![]() ![]() ![]() ![]() 18-27 However, less data is available in the literature concerning unselected populations in which the new definition of AMI is applied and long-term follow-up performed. 11-17 Recent studies have supported the prognostic value of the WBC as a predictor of the development of heart failure and death in both the short term and long term following ACS, particularly following acute myocardial infarction (AMI). Various publications have shown that increased white blood cell count (WBC) is associated with a higher incidence of cardiovascular disease and all-cause mortality in the general population. Consequently, their usefulness is limited in day to day clinical practice. 5-10 However, the majority of these markers are not universally available, their cost is high, and results are not usually available immediately. 1-4 Recent studies have shown that increased levels of certain inflammatory markers in patients with acute coronary syndrome (ACS) are associated with an increased number of cardiovascular complications and a higher incidence of death, both in the short term and in the long term. In recent years, increasing evidence has become available supporting the role of inflammation in the development of atherosclerosis and the pathogenesis of coronary thrombosis. WBC on admission was an independent predictor of long-term mortality in both non-STEMI and STEMI patients. In non-STEMI patients, the adjusted hazard ratios for those in the WBC3 and WBC2 groups compared with those in the WBC1 group were 2.07 (1.08-3.94 P=.027) and 1.61 (1.03-2.51 P=.036), respectively. Long-term mortality during follow-up was 18.5% in non-STEMI patients and 19.9% in STEMI patients. The relationship between WBC and mortality was assessed by Cox regression analysis for both types of AMI. All-cause mortality was recorded during a median follow-up period of 10☒ months. Patients were divided into 3 groups: WBC1 (count, <10x103 cells/mL), WBC2 (count, 10-14.9x10³ cells/mL), and WBC3 (count, ≥15x10³ cells/mL). The WBC was measured in the 24 hours following admission. The study included 1118 consecutive patients who were admitted with the diagnosis of AMI: 569 non-STEMI and 549 STEMI. The present study was designed to assess the association between WBC and long-term mortality in AMI patients either with ST-segment elevation (STEMI) or without ST-segment elevation (non-STEMI). Although traditionally an elevated white blood cell count (WBC), an indicator of systemic inflammation, has been accepted as part of the healing response following acute myocardial infarction (AMI), it has frequently been shown to be a predictor of adverse cardiovascular events. ![]()
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