Coronary artery diseaseComparison of Usefulness of C-reactive Protein Versus White Blood Cell Count to Predict Outcome After Primary Percutaneous Coronary Intervention for ST Elevation Myocardial Infarction
Section snippets
Methods
This study concerns a subanalysis of data from the On-TIME trial, a prospective, double-blind, randomized controlled trial investigating early versus late initiation of Tirofiban in STEMI.17 In brief, the 507 patients who were included experienced either >30 minutes of chest pain with >0.2 mV (anterior myocardial infarction) or 0.1 mV (nonanterior myocardial infarction) of ST elevation in 2 contiguous electrocardiographic leads and were available for primary angioplasty within 6 hours after the
Results
In 490 patients (97%) included in the On-TIME trial, either WBC count or CRP was measured. A WBC count was available in 473 of 507 (93%), and in 379 (75%) patients, CRP was measured. Both markers were available in 362 (71%) patients. The baseline characteristics are shown in Table 1. There were no important differences between total included patients in the On-TIME trial and those in which WBC count and/or CRP were determined. The baseline characteristics according to elevated CRP or WBC count
Discussion
This study is the first to compare the prognostic importance of CRP and WBC counts on outcome after primary percutaneous coronary intervention for STEMI. No relationship between CRP and WBC count was found, and the mechanisms by which WBC counts predict outcome are infarct size-related, in contrast to CRP.
Higher levels of CRP have been associated with worse outcome after acute myocardial infarction in multiple studies.4, 5, 6, 7, 8, 9, 10, 11 Even in stable condition, 25 days after a myocardial
Acknowledgment
This study was supported with an educational grant from Merck & Co. The authors thank Vera Derks for preparing this manuscript.
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