Association of non-specific inflammatory activation with early mortality in patients with ST-elevation acute coronary syndrome treated with primary angioplasty

Abstract

Background: The association of inflammatory markers with mortality in ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) remains controversial, so in the present study the relationships of high-sensitivity C-reactive protein (hs-CRP), total white blood cell (WBC) count, neutrophil (N) and lymphocyte (L) counts and the N/L ratio with occurrence of in-hospital mortality were assessed in patients with STEMI treated with primary PCI. Methods and Results: Inflammatory parameters were assessed on admission in 1,078 consecutive, unselected patients with STEMI admitted for primary PCI. In-hospital death occurred in 6.3% of the patients. Of the inflammatory parameters, only hs-CRP (p<0.001), and the WBC (p=0.004) and N (p=0.020) counts were predictors of death in the univariate analyses. After adjustment for other baseline clinical variables both hs-CRP and WBC count retained their independent association with mortality when analyzed both in 2 separate and in 1 multivariable models. Conclusions: Both hs-CRP and the WBC count may independently of each other predict early outcomes in STEMI patients treated with primary PCI, which suggests different pathological significance of these 2 non-specific inflammatory markers in STEMI.