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Year : 2022  |  Volume : 11  |  Issue : 1  |  Page : 10-14

Effect of white blood cell indices and glycemia on inhospital prognosis of ST-segment elevated myocardial infarction

Department of Medicine, Government Medical College, Aurangabad, Maharashtra, India

Correspondence Address:
MD Dnyaneshwar V Jadhav
Department of Medicine, Government Medical College Aurangabad - 431 001, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcpc.jcpc_52_21

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Background: Early risk stratification is recommended in daily clinical practice to predict adverse outcomes in patients with ST-segment elevation myocardial infarction (STEMI). Complete blood count and blood glucose analysis is routinely performed on admission. Hence, this study was undertaken to find out the predictive value of white blood cell (WBC) indices and glycemia to know adverse outcomes in STEMI. Methods: In an observational study conducted between December 2015 and October 2018 at a tertiary center, 400 patients with acute STEMI were included. Results: We had 400 patients of STEMI. In this study, mean total leukocyte count (TLC), total neutrophil count (TNC), neutrophil-to-lymphocyte ratio (NLR), and plasma glucose were higher in those with complications (13,449.8/mm3, 10,460.5/mm3, 5.20 and 180.8 mg%) than those without complications (11,318.3/mm3, 8581.9/mm3, 4.15, and 151.1 mg%) (P < 0.05). The cutoff point of TLC >13 × 1000 cells/mm3 had a sensitivity of 73.5% and specificity of 63% in predicting postmyocardial infarction mortality (area under the curve = 0.68, P < 0.001). Patients with acute hyperglycemia (≥140 mg%) had higher incidence of hypotension (31.12% vs. 17.64%, P < 0.05), left ventricular failure (32.14% v/s. 21.1%, P < 0.05), ventricular arrhythmias (13.26% vs. 6.86%, P < 0.05), and higher inhospital mortality (P = 0.0001). Multivariate analysis predicting inhospital mortality as dependent variable TLC >13 × 1000 cells/mm3, TNC >10.5 × 1000 cells/mms3, NLR ≥5.20, and plasma glucose >140 mg/dl were the variable found to be statistically significant (P < 0.05). Conclusion: The WBC indices (TLC, TNC, and NLR) and plasma glucose on admission are independent predictors of major cardiovascular events and inhospital mortality in STEMI.

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