The Prognostic Value of Mean Platelet Volume in Acute Myocardial Infarction

Lee, Ju Hwan; Kim, Hyung Seop; Kwon, Yong Seop; Lee, Hyun Sang; Park, Man Gee; Heo, Jung Ho; Yang, Dong Heon; Park, Hun Sik; Cho, Yong Keun; Chae, Shung Chull; Jun, Jae Eun; Park, Wee Hyun

doi:10.4070/kcj.2003.33.10.878

Cited by 1 publication

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“…Several studies have suggested that neutrophil counts at the time of initial presentation in patients with STEMI can predict outcomes at both short- and long-term follow-up evaluations 1)4-10)21-24). There was no significant difference in the 9-month MACE rate between the neutrophil tertiles.…”

Section: Discussionmentioning

confidence: 94%

Effect of Aspiration Thrombectomy on Microvascular Dysfunction in ST-Segment Elevation Myocardial Infarction With an Elevated Neutrophil Count

Lee

Kim

et al. 2011

Korean Circ J

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Background and ObjectivesAspiration thrombectomy (AT) during primary percutaneous coronary intervention (PCI) is an effective adjunctive therapy for ST-segment elevation myocardial infarction (STEMI). An elevated neutrophil count in STEMI is associated with microvascular dysfunction and adverse outcomes. We evaluated whether AT can improve microvascular dysfunction in patients with STEMI and an elevated neutrophil count.Subjects and MethodsSeventy patients with STEMI undergoing primary PCI from August 2007 to February 2009 in our institution were classified by tertiles of neutrophil count on admission (<5,300/mm3, 5,300-7,600/mm3, and >7,600/mm3). The angiographic outcome was post-procedural thrombolysis in myocardial infarction (TIMI) flow grade. Microvascular dysfunction was assessed by TIMI myocardial perfusion (TMP) grade and ST-segment resolution on electrocardiography 90 minutes after PCI. The clinical outcome was major adverse cardiac event (MACE), defined as cardiac death, re-infarction, and target lesion revascularization at 9 months.ResultsThere were no significant differences in the clinical characteristics and pre- and post-procedural TIMI flow grades between the neutrophil tertiles. As the neutrophil count increased, a lower tendency toward TMP grade 3 (83% vs. 52% vs. 54%, p=0.06) and more persistent residual ST-segment elevation (>4 mm: 13% vs. 26% vs. 58%, p=0.005) was observed. The 9-month MACE rate was similar between the groups. On subgroup analysis of AT patients (n=52) classified by neutrophil tertiles, the same tendency toward less frequent TMP grade 3 (77% vs. 56% vs. 47%, p=0.06) and persistent residual ST-segment elevation (>4 mm: 12% vs. 28% vs. 53%, p=0.05) was observed as neutrophil count increased.ConclusionA higher neutrophil count at presentation in STEMI is associated with more severe microvascular dysfunction after primary PCI, which is not improved with AT.

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