Relationship Between Hematological Parameters and Myocardial Perfusion in Patients with Acute Anterior Myocardial Infarction Managed by Primary Percutaneous Coronary Intervention

Abstract

cute myocardial infarction (AMI) is one of the leading causes of death worldwide. AMI is a major public health burden with high mortality out of the hospital. Data indicate that at least one-third of patients die before coming to the hospital and another 40-50% are dead upon arrival. On the other hand, the treatment of ST-segment elevation myocardial infarction (STEMI) has advanced dramatically over the past 30 years since the introduction of reperfusion therapy, with early access to reperfusion critical to good clinical outcomes. In patients presenting with STEMI, primary percutaneous coronary intervention (PCI) is considered the optimal reperfusion strategy. Despite this wide use of primary PCI to re‐establish anterograde flow after AMI, complete recovery of myocardial perfusion may not be achieved with this procedure alone. Therefore, it is critical to identify patients with a high risk of ‘no reflow’ phenomena in order to improve short- and long-term adverse clinical outcomes. Recent data have shown that there is an increase in myeloid activity in AMI and it has arisen strong interest in hematological parameters, total leucocytic count (TLC) elevation was found to be a relevant death risk factor during the first 30 days and 6 months following the myocardial infarction. In addition, the neutrophil to lymphocyte ratio (NLR) was found to significantly predict the short and long-term mortality in patients with AMI. Therefore, the aim of the present study is to evaluate the relationship between TLC, NLR and myocardial perfusion in patients with acute anterior STEMI managed by primary PCI.