Prognostic significance of peripheral monocytosis after reperfused acute myocardial infarction:a possible role for left ventricular remodeling - PubMed (original) (raw)
Prognostic significance of peripheral monocytosis after reperfused acute myocardial infarction:a possible role for left ventricular remodeling
Yuichiro Maekawa et al. J Am Coll Cardiol. 2002.
Free article
Abstract
Objectives: The aim of this study was to determine the significance of peripheral monocytosis in clinical outcome after reperfused acute myocardial infarction (AMI), especially relating to post-infarct left ventricular (LV) remodeling.
Background: Peripheral monocytosis occurs two to three days after AMI, reflecting infiltration of monocytes and macrophages into the necrotic myocardium. However, the prognostic significance of peripheral monocytosis after AMI remains to be determined.
Methods: A total of 149 patients with first Q-wave AMI were studied. White blood cell (WBC) count, percentage of monocytes and serum C-reactive protein level were measured every 24 h for four days after the onset of AMI. We assessed association between peripheral monocytosis and prognosis including pump failure, LV aneurysm and long-term outcome after AMI.
Results: Patients with pump failure (p < 0.0001) or LV aneurysm (p = 0.005) had higher peak monocyte counts than those without these complications. Predischarge left ventriculography revealed that peak monocyte count was positively correlated with LV end-diastolic volume (p = 0.024) and negatively correlated with ejection fraction (p = 0.023). Multivariate analyses showed that peak monocyte count > or = 900/mm(3) was an independent determinant of pump failure (relative risk [RR] 9.83, p < 0.0001), LV aneurysm (RR 4.78, p = 0.046) and cardiac events (RR 6.30, p < 0.0001), including readmission for heart failure, recurrent myocardial infarction and cardiac deaths, including sudden deaths.
Conclusions: Peripheral monocytosis is associated with LV dysfunction and LV aneurysm, suggesting a possible role of monocytes in the development of LV remodeling after reperfused AMI.
Comment in
- Monocytosis and adverse left ventricular remodeling after reperfused myocardial infarction.
Jugdutt BI. Jugdutt BI. J Am Coll Cardiol. 2002 Jan 16;39(2):247-50. doi: 10.1016/s0735-1097(01)01733-8. J Am Coll Cardiol. 2002. PMID: 11788215 No abstract available. - Prognostic significance of immune activation after acute coronary syndromes.
Auer J, Berent R, Lassnig E, Weber T, Eber B. Auer J, et al. J Am Coll Cardiol. 2002 Jun 5;39(11):1878. doi: 10.1016/s0735-1097(02)01875-2. J Am Coll Cardiol. 2002. PMID: 12039508 No abstract available.
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