High total leukocyte count and heart failure after myocardial infarction

ABSTRACT

Acute myocardial infarction ST-elevation [STEMI] is frequently associated with leukocytosis and relative increased in neutrophil count. It is believed that the peripheral leukocyte count have important prognostic implication in AMI. In this study we hypothesized that there is an association between absolute leukocytosis and neutrophilia to the short term development of congestive heart failure [CHF] after AMI. A cross sectional study carried out from June -August 2010. 200 patients with diagnosis of STEMI were included. Patients with a history of chest pain of more than 12 hours, recent trauma, infection, malignancy were excluded. Baseline demographic data was obtained. Blood sample was drawn for leukocyte count within 12 hours of admission.Echocardiogram [Echo] and X-ray chest was obtained during first four days. Chi square test was applied to seek association between high total leukocyte [TLC] and heart failure. Out of 200 patients, 98 [49%] remained uncomplicated and they were discharged without clinical evidence of CHF; whereas 91[45.5%] patients who developed clinical CHF underwent Echo and discharged later. Total 11[5.5%] patients expired in hospital. Out of 91 patients who developed CHF 61[67%] had high TLC [>11000 mm3], while 30 [33%] had normal [<11000 mm3] TLC. Significant association [P<0.008] of high TLC with development of CHF was observed.81 [89%] patients had high neutrophil count [>65 mm3], while 10 [11%] had normal [association [p < 0.016] of neutrophilia with development of CHF was observed. This study shows that high TLC count appears to be associated with development of CHF and mortality after acute STEMI