BASELINE LEUKOCYTE COUNT AND ACUTE CORONARY SYNDROME: PREDICTOR OF ADVERSE CARDIAC EVENTS, LONG AND SHORT TERM MORTALITY AND ASSOCIATION WITH TRADITIONAL RISK FACTORS, CARDIAC BIOMARKERS AND CREACTIVE PROTEIN

Authors

  • Tahir Ahmad Munir
  • M Nasir Afzal
  • Habib -ur- Rehman

Abstract

Background: The elevated WBC count has been accepted as part of healing response following
myocardial infarction as well as a predictor of adverse cardiovascular events. The study was designed
to find out correlation between WBC count and coronary risk factors, cardiac biomarkers, C-reactive
protein (CRP), incidence of adverse cardiac events and mortality in patients of ACS in Pakistan.
Methods: One hundred and thirty-three patients of ACS were stratified according to WBC categories,
WBC1 (<7000/mm3), WBC2 (7100-10,000/mm3) and WBC3 (>10,000/mm3). The WBCs were
counted on admission by Sysmex cell counter, CRP by immunoturbidimetric method, and CK-MB and
Trop-I by enzyme immunoassay. Adverse cardiac events and mortality were recorded for 12 months of
follow up period. Results: Long term mortality in patients with ACS was 6.4% in WBC1, 18.2% in
WBC2 and 40.9% in WBC3 categories, while short term mortality was 2.6%, 3.0% and 18.2% in
WBC1, WBC2, and WBC3 categories respectively. Relative to patients in lower 2 WBC categories,
patients in the highest category were 7 times more likely to die during 30 days (HR 7.83, p=0.017) and
more than 9 times during the total follow up period (HR 9.42, p<0.001). Cox regression analysis
showed WBC3 a strong independent predictor of mortality (HR 6.36, p=0.016). WBC count showed a
positive correlation with coronary risk factors, cardiac biomarkers and CRP. Conclusion: WBC count
is a strong independent predictor of mortality in patients with ACS and has positive correlation with
coronary risk factors, cardiac biomarkers and CRP.
Keywords: Acute coronary syndrome, WBCs, Mortality, C-reactive protein

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Published

2009-09-01

How to Cite

Munir, T. A., Afzal, M. N., & Rehman, H. .- ur-. (2009). BASELINE LEUKOCYTE COUNT AND ACUTE CORONARY SYNDROME: PREDICTOR OF ADVERSE CARDIAC EVENTS, LONG AND SHORT TERM MORTALITY AND ASSOCIATION WITH TRADITIONAL RISK FACTORS, CARDIAC BIOMARKERS AND CREACTIVE PROTEIN. Journal of Ayub Medical College Abbottabad, 21(3), 46–50. Retrieved from https://jamc.ayubmed.edu.pk/index.php/jamc/article/view/3186

Issue

Vol. 21 No. 3 (2009): JOURNAL OF AYUB MEDICAL COLLEGE, ABBOTTABAD

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ORIGINAL ARTICLE

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