Relationship between leucocytosis and left ventricular ejection fraction in patients with acute myocardial infarction

<p><b>INTRODUCTION</b>Myocardial infarction (MI) is common and affects a significant number of people annually. Death occurs due to either arrhythmia or heart failure. As leucocytosis, especially elevated neutrophil count, is a hallmark of inflammatory reactions in patients with MI, we investigated the relationship between leucocytosis on admission and left ventricular ejection fraction (LVEF) in patients with acute MI (AMI).</p><p><b>METHODS</b>Patients with AMI were enrolled in a case-control study. Blood samples obtained in the first 24 hours after the onset of pain were analysed for cardiac enzyme levels and cell count. Echocardiography was performed on Days 3-5. Patients with LVEF < 45% were assigned to the left ventricular (LV) systolic dysfunction group (n = 69) and those with LVEF ≥ 45% were taken as controls (n = 69). All patients were matched for variables such as hypertension, diabetes mellitus, hyperlipidaemia, family history of cardiac disease, age and gender.</p><p><b>RESULTS</b>Leucocytosis was higher in patients with systolic dysfunction (47.8%) when compared with the controls (20.3%), and was significantly associated with the development of LV systolic dysfunction (p = 0.001). Similarly, neutrophilia was more common in patients with systolic dysfunction than the controls (6.6% vs. 34.8%), and was significantly associated with LV systolic dysfunction (p < 0.001). Monocytosis was higher in the controls than the systolic dysfunction group (40.6% vs. 33.3%; p = 0.378).</p><p><b>CONCLUSION</b>Leucocytosis and neutrophilia in the acute phase of MI are important predictive factors for the development of LV systolic dysfunction. Leucocytosis can be used for risk stratification of such patients.</p>

Leukocyturia and coronary artery disease: further evidence to the presence of inflammatory processes in acute coronary syndrome

Cardiovascular disease is the main cause of mortality in developing countries. Because the major classic risk factors fail to explain the disease's epidemiologic diversity, other risk factors such as inflammation and systemic infections are being investigated, although no cause and effect relation between these infections and acute coronary syndrome [ACS] has yet been decisively proven. In view of the possible role of local and systemic infections in the occurrence of ACS, as well as leukocyturia and hematuria, the present study was designed and carried out. This was a prospective case-control study of all patients diagnosed as having ACS and hospitalized at the CCU of Fatemiyeh Hospital in Semnan. Urine analysis and culture were performed in all patients and the control group in the early stage of admission to the CCU. After collecting data, we examined the associations and the differences between the two groups by using t-test and chi-square test. The case and control groups did not show any significant difference based on age and sex [age 60.03 +/- 19.32 years in cases and 59.9 +/- 17.2 years in controls, female prevalence was 40.5% in both groups]. Hematuria was seen in 18.5% of cases and 5% of controls [P<0.0001]. Leukocyturia was seen in 28.5% of cases and 12% of controls [P<0.0001]. Albuminuria was seen in 6% of cases and 7% of controls [P>0.05]. These findings indicated the presence of sub-clinical underlying infection process due to uncommon pathogens or leukocyturia and hematuria in a systemic inflammatory process that can predispose to ACS by systemic inflammation