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Systemic inflammatory response in acute coronary syndrome- increased WBC count and PMN percentage as a predictor of severity of clinical presentation

SYSTEMIC INFLAMMATORY RESPONSE IN ACUTE CORONARY SYNDROME- INCREASED WBC COUNT AND PMN PERCENTAGE AS A PREDICTOR OF SEVERITY OF CLINICAL PRESENTATION V. Raos, Z. Trstenjak , M. Raguž, B. Starčević, M. Bergovec Department of Cardiology, University Hospital Dubrava, Zagreb, Croatia Objectives:Inflammatory mechanisms have a crucial role in pathogenesis of acute coronary syndrome (ACS), which includes unstable angina (UA) and acute myocardial infarction (AMI). The aim of this study was to assess whether classic inflammation markers (total white blood cells count (WBC), polymorphonuclear count (PMN), CRP, fibrinogen and SE-sedimentation of eritrocytes) are associated with the severity of ACS presentation. Methods: The study randomised 60 patients with the diagnosis of ACS (40 men and 20 women). 41 patient had AMI, and other 19 had UA ; average age 64, 1 years. Only 25 patients underwent urgent coronary angiography (two of them had normal finding on the coronary arteries). Blood samples were obtained right after admission from every patient. Total WBC count and PMN percentage were performed on Sysmex-4500. In statistical analysis we used Statistica 6.1 software program. P < 0, 05 is considered statistically significant. Results: Total WBC count and PMN percentage is significantly higher in patients with AMI compared with the patients with UA (P=0, 006 for WBCs and P=0, 01 for PMN percentage). Subsequently, the percentage of lymphocytes was significantly lower in the group with AMI (P=0, 02). Patients with UA (n=20) Patients with AMI (n=40) t-value P WBC (cells/ml) 7862, 11± ; 2176, 44 9956, 00± ; 2824, 40 -2, 84 0, 006 PMN (%) 64, 32± ; 8, 84 71, 08± ; 9, 56 -2, 59 0, 01 LY (%) 25, 69± ; 7, 80 20, 36± ; 8, 60 2, 29 0, 02 CRP (mg/l) 10, 75± ; 15, 25 40, 10± ; 68, 55 -1, 78 0, 07 Conclusions: To conclude, our findings, together with similar previously reported studies, suggest that the degree of systemic inflammatory response follows the severity of clinical presentation of ACS. This knowledgement might have important diagnostical and therapeutical implications in the treatment of ACS in the future.

inflammation; polymorphonuclears; white blood cell count; acute coronary syndrome

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