Basophil count as a prognosis biomarker after STEMI - 25/09/20
Résumé |
Background |
White blood cell count (lymphocyte, neutrophil, eosinophil) have been shown to be independently and incrementally associated with clinical events after acute myocardial infarction (MI). However, the prognostic value of basophil has never been studied at the acute phase of MI.
Objective |
Our objective was to define the kinetics of basophils within the first month in patients admitted for STEMI and to assess their prognostic value.
Methods |
We prospectively enrolled 243 patients admitted for acute ST elevated MI (STEMI) from 2016 to 2019. Blood samples were collected at 5 time points: admission, 4, 24, 48hours and 1 month after admission (H4, H24, H48, M1). Patients underwent cardiac magnetic resonance imaging at one month for infarct size (IS) and left ventricular ejection fraction (LVEF) assessment. Clinical outcomes were prospectively recorded over 18 months.
Results |
Patient mean age was 59±12years. Basophil count significantly decreased at H24 with a median of 30.0Mega/L (interquartile range [IQR] [20.0–50.0]) compared to admission (40.0M/L IQR [30.0–60.0], P<0.001) and was back to baseline level at H48. Basophils at H48 were not associated with IS assessed by CMR (r=−0.08, P=0.32), LVEF (r=−0.12, P=0.08) or LV end diastolic volume (r=−0.03, P=0.68). Patients with H48 basophil level below the median value of the population were more likely to have an adverse clinical event (MI, stroke, hospitalization for heart failure and all-cause death) during the 18 months follow-up compared to patients with basophil level above the median (hazard ratio at 6.1 [2.5–15.0], P=0.005). In a multivariable Cox regression analyses with models including peak troponin I, LVEF and age, low levels of basophils at H48 remained associated with an increased risk of adverse clinical event. Area under the receiver operating curve was 0.68 (0.57–0.78), P=0.005 (Fig. 1).
Conclusion |
Basophil count at H48 in STEMI patients is an independent prognosis marker to predict clinical outcome.
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Vol 12 - N° 2-4
P. 227 - octobre 2020 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.