Coronary artery diseaseAssociation of Leukocyte and Neutrophil Counts With Infarct Size, Left Ventricular Function and Outcomes After Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction
Section snippets
Methods
Details of the Evaluation of MCC-135 for Left Ventricular Salvage in Acute Myocardial Infarction (EVOLVE) trial have been published previously.4, 5 In brief, EVOLVE was a phase IIA, multicenter, randomized, double-blind, placebo-controlled study of the safety and efficacy of 2 doses of intravenous MCC-135, a new class of agent that reduces intracellular calcium overload, as an adjunct therapy for the preservation of LV function and reduction of infarct size in patients who undergo PCI for
Results
In this analysis, we included 363 patients (73% of the patients enrolled in the EVOLVE study) who had white cell counts assessed within 24 hours of admission, underwent primary PCI, and underwent follow-up SPECT imaging. Clinical characteristics of the study cohort and procedural findings are listed in Table 1. The profiles of total leukocyte, neutrophil, and lymphocyte counts from time of admission to 30 days thereafter are shown in Figure 1. Total leukocyte and neutrophil counts were modestly
Discussion
The major findings of the present study are that (1) elevated leukocyte and neutrophil counts after primary PCI are related to adverse clinical outcomes in patients with STEMIs, (2) there is direct correlation between leukocyte counts and myocardial infarct size and LV function determined by SPECT imaging, and (3) high leukocyte and neutrophil counts postprocedurally are independent predictors of cardiovascular outcomes.
The association between thrombotic and inflammatory pathways in acute
Acknowledgment
We would like to thank the EVOLVE Scientific Advisory Committee and Data Safety and Monitoring Committee and all the participating investigators and institutions in the EVOLVE study.
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Cited by (0)
Dr. Chia is the recipient of the National Medical Research Council Medical Research Fellowship and Health Manpower Development Program Fellowship, Singapore. The Evaluation of MCC-135 for Left Ventricular Salvage in Acute Myocardial Infarction (EVOLVE) study was supported by a grant from Mitsubishi Pharma Corporation, Osaka, Japan.