Printer Friendly

Elevated WBC at acute MI admission raises mortality. (Acute Coronary Syndromes).

ANAHEIM, CALIF. -- An elevated white blood cell count is a simple, independent predictor of mortality over the next 6 months in patients hospitalized for an acute coronary syndrome, Dr. Michael Hung-Hwa Yen said at the annual scientific sessions of the American Heart Association.

"This is true even within a range of WBC counts that's considered normal--between 5,000 and 10,000/[mu]L," said Dr. Yen of the Cleveland Clinic Foundation.

This finding--from a retrospective analysis of 2,253 patients with unstable angina or non-Q-wave MI enrolled in the Platelet IIb/IIIa Antagonism for the Reduction of Acute Coronary Syndrome Events in a Global Organization Network-A (PARAGON A) trial--confirms the role of inflammation in acute coronary syndromes.

An elevated WBC is not a specific marker of inflammation. But compared with specific inflammatory markers such as C-reactive protein tumor necrosis factor, and interleukin 6, the admission WBC offers the advantages of being universally available and easily interpreted at a glance.

Patients in the bottom quartile for WBC--a value of 6,800/[mu]L or less--had a 6-month all-cause mortality of 4.6%. With each successive WBC quartile, mortality climbed by an absolute 1% such that individuals in the top quartile, with a WBC greater than 9,800/pt, had a 6-month mortality of 7.6%. The median WBC in PARAGON A was roughly 8,000/[mu]t. This was associated with a 6-month mortality of 6%. Mortality was nearly twice as high in a patient who presented with a WBC of 15,000/[mu]L.

After adjusting for demographic factors, comorbidities, and treatment strategy admission WBC remained an independent predictor. For each 1,000 [mu]L of WBC, the 6-month mortality risk rose by 9.3%. A WBC of l0,000/mL in PARAGON-A participants conferred a mortality risk comparable to that of having diabetes.
COPYRIGHT 2002 International Medical News Group
No portion of this article can be reproduced without the express written permission from the copyright holder.
Copyright 2002 Gale, Cengage Learning. All rights reserved.

Article Details
Printer friendly Cite/link Email Feedback
Title Annotation:white blood cells, myocardial infarction, the medical term for a heart attack
Publication:Internal Medicine News
Date:Feb 15, 2002
Previous Article:Chest compression--only CPR beats mouth-to-mouth CPR. (Higher Survival Rate).
Next Article:Acupuncture reduces symptoms of congestive heart failure. (Sympathetic Activity).

Related Articles
Fatal cardiac rupture during stress exercise testing: case series and review of the literature.
Measure fasting glucose in nondiabetic MI patients.
Hyperglycemia may be mortality risk after MI.
Clinical differences may explain higher mortality in renal patients after MI.
Gender differences persist in treatment, survival after MI.
Update on ACC/ESC criteria for acute ST-elevation myocardial infarction.
Myocardial infarction redefined--a consensus document of the Joint European Society of Cardiology/American College of Cardiology Committee for the...

Terms of use | Copyright © 2017 Farlex, Inc. | Feedback | For webmasters