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White Blood Cell Subtypes after STEMI: Temporal Evolution, Association with Cardiovascular Magnetic Resonance—Derived Infarct Size and Impact on Outcome

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Abstract

The evolution of white blood cells after ST elevation myocardial infarction (STEMI) and their association with infarct size and major adverse cardiac events (MACE) remains unclear. Two hundred eleven patients underwent CMR after STEMI. Infarct mass (grams) was determined. Neutrophil, lymphocyte, and monocyte counts (×1,000 cells/ml) were measured upon arrival and at 12, 24, 48, 72, and 96 h. Patients with large infarctions (3rd tertile ≥ 28.5 g vs. 1st and 2nd tertiles < 28.5 g) showed a larger neutrophil count at 12 h (14.8 ± 4.8 vs. 11.4 ± 3.3, p < 0.0001) and an increased monocyte count (maximum at 24 h (0.65[0.50–0.91] vs. 0.55[0.42–0.71], p = 0.004)) but no difference in lymphocyte count. Neutrophil count at 12 h independently predicted large infarctions (OR 1.14, 95%CI [1.04–1.26], p = 0.008). During follow-up (median 504 days), 25 MACE occurred. Neutrophil count at 96 h independently predicted MACE (HR 1.2, 95%CI [1.1–1.4], p = 0.003). Large infarctions show a marked neutrophil peak and an increasing monocyte count. Neutrophil count independently predicts large infarctions and MACE.

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Abbreviations

CMR:

Cardiovascular magnetic resonance imaging

STEMI:

ST elevation myocardial infarction

MACE:

Major adverse cardiac events

TIMI:

Thrombolysis in myocardial infarction

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Acknowledgments

This study was supported by the “Instituto de Salud Carlos III” with FIS PI080128 and Heracles grants and by the Spanish Society of Cardiology with a FEC grant.

Conflict of interest statement

No conflict of interest exists in the present study.

Author information

Authors and Affiliations

  1. Department of Cardiology, Hospital Clinico Universitario, INCLIVA, Universidad de Valencia, Blasco Ibanez 17, 46010, Valencia, Spain

    Oliver Husser, Vicente Bodi, Juan Sanchis, Julio Nunez, Luis Mainar, Francisco Javier Chorro, Fabian Chaustre, Maria J. Forteza, Isabel Trapero, Francisco Dasi & Angel Llacer

  2. Klinik und Poliklinik für Innere Medizin II, University of Regensburg Medical Center, Regensburg, Germany

    Oliver Husser & Günter A. J. Riegger

  3. Unit of Cardiovascular Magnetic Resonance Imaging, ERESA, Valencia, Spain

    Maria Pilar Lopez-Lereu & Jose Vicente Monmeneu

  4. Department of Hematology, Hospital Clinico Universitario, INCLIVA, Universidad de Valencia, Valencia, Spain

    Isabel Benet

Authors
  1. Oliver Husser
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  2. Vicente Bodi
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  3. Juan Sanchis
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  4. Julio Nunez
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  7. Maria Pilar Lopez-Lereu
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  9. Fabian Chaustre
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  10. Maria J. Forteza
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  11. Isabel Trapero
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  13. Isabel Benet
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  14. Günter A. J. Riegger
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  15. Angel Llacer
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Corresponding author

Correspondence to Vicente Bodi.

Electronic supplementary material

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Online Table 1

Cardiac catheterization data of the whole study group and of patients with and without large infarction (DOC 31 kb)

Online Table 2

Cardiac catheterization data of patients with and without major adverse cardiac events (DOC 31 kb)

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Husser, O., Bodi, V., Sanchis, J. et al. White Blood Cell Subtypes after STEMI: Temporal Evolution, Association with Cardiovascular Magnetic Resonance—Derived Infarct Size and Impact on Outcome. Inflammation 34, 73–84 (2011). https://doi.org/10.1007/s10753-010-9209-0

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  • DOI: https://doi.org/10.1007/s10753-010-9209-0

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