ST段抬高型心肌梗死后炎症在早期左心室血栓形成中的作用--一项匹配病例对照研究

IF 2.4 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Clinical Cardiology Pub Date : 2024-10-16 DOI:10.1002/clc.70031

Batia Litmanowicz, Moran Gvili Perelman, Michal Laufer-Perl, Yan Topilsky, Shmuel Banai, Yacov Shacham, Shafik Khoury

{"title":"ST段抬高型心肌梗死后炎症在早期左心室血栓形成中的作用--一项匹配病例对照研究","authors":"Batia Litmanowicz, Moran Gvili Perelman, Michal Laufer-Perl, Yan Topilsky, Shmuel Banai, Yacov Shacham, Shafik Khoury","doi":"10.1002/clc.70031","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Background</h3>\n \n <p>There is limited data on the association between inflammation and the formation of early left ventricular thrombus (LVT) following ST-elevation myocardial infarction (STEMI). This study aimed to explore the predictive value of several inflammatory biomarkers for LVT formation following STEMI.</p>\n </section>\n \n <section>\n \n <h3> Methods and Results</h3>\n \n <p>Our cohort included 2534 consecutive patients admitted to the cardiac intensive care unit (CICU) with STEMI. The final analysis included 51 patients with LVT and 102 patients without LVT, matched for age, sex, anterior infarct and ejection fraction. Upon admission, patients with LVT had higher white blood cell counts (WBC) (12.8 ± 7 vs. 12.4 ± 4 ×10<sup>3</sup>/µL, <i>p</i> = 0.01), higher absolute neutrophil counts (10.5 ± 4 vs. 8.6 ± 4 ×10<sup>3</sup>/µL, <i>p</i> = 0.003), neutrophil-to-lymphocyte ratio (8.2 ± 6 vs. 4.8 ± 4, <i>p</i> = 0.04), and C-reactive protein (CRP) levels (35.9 ± 62 vs. 18.6 ± 40 mg/L, <i>p</i> = 0.04). Peak values for WBC and CRP were also higher in the LVT group (17.8 ± 8 vs. 14.6 ± 5 ×10<sup>3</sup>/µL, <i>p</i> = 0.003 and 95.8 ± 82 vs. 64.2 ± 76 mg/L, <i>p</i> = 0.02, respectively). In univariate regression analysis, WBC upon admission (OR: 1.12, 95% CI: 1.02–1.21, <i>p</i> = 0.02), peak WBC (OR: 1.09, 95% CI: 1.02–1.17, <i>p</i> = 0.009), neutrophil count upon admission (OR: 1.15, 95% CI: 1.04–1.26, <i>p</i> = 0.004), and peak CRP (OR: 1.01, 95% CI: 1–1.01, <i>p</i> = 0.03) predicted LVT formation, which was also evident in multivariate regression models.</p>\n </section>\n \n <section>\n \n <h3> Conclusion</h3>\n \n <p>WBC and neutrophil counts upon admission, as well as peak WBC and CRP, have additional predictive value for LVT formation following STEMI, beyond classical risk factors.</p>\n </section>\n </div>","PeriodicalId":10201,"journal":{"name":"Clinical Cardiology","volume":"47 10","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70031","citationCount":"0","resultStr":"{\"title\":\"The Role of Inflammation in Early Left Ventricular Thrombus Formation Following ST-Elevation Myocardial Infarction—A Matched Case-Control Study\",\"authors\":\"Batia Litmanowicz, Moran Gvili Perelman, Michal Laufer-Perl, Yan Topilsky, Shmuel Banai, Yacov Shacham, Shafik Khoury\",\"doi\":\"10.1002/clc.70031\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Background</h3>\\n \\n <p>There is limited data on the association between inflammation and the formation of early left ventricular thrombus (LVT) following ST-elevation myocardial infarction (STEMI). This study aimed to explore the predictive value of several inflammatory biomarkers for LVT formation following STEMI.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods and Results</h3>\\n \\n <p>Our cohort included 2534 consecutive patients admitted to the cardiac intensive care unit (CICU) with STEMI. The final analysis included 51 patients with LVT and 102 patients without LVT, matched for age, sex, anterior infarct and ejection fraction. Upon admission, patients with LVT had higher white blood cell counts (WBC) (12.8 ± 7 vs. 12.4 ± 4 ×10<sup>3</sup>/µL, <i>p</i> = 0.01), higher absolute neutrophil counts (10.5 ± 4 vs. 8.6 ± 4 ×10<sup>3</sup>/µL, <i>p</i> = 0.003), neutrophil-to-lymphocyte ratio (8.2 ± 6 vs. 4.8 ± 4, <i>p</i> = 0.04), and C-reactive protein (CRP) levels (35.9 ± 62 vs. 18.6 ± 40 mg/L, <i>p</i> = 0.04). Peak values for WBC and CRP were also higher in the LVT group (17.8 ± 8 vs. 14.6 ± 5 ×10<sup>3</sup>/µL, <i>p</i> = 0.003 and 95.8 ± 82 vs. 64.2 ± 76 mg/L, <i>p</i> = 0.02, respectively). In univariate regression analysis, WBC upon admission (OR: 1.12, 95% CI: 1.02–1.21, <i>p</i> = 0.02), peak WBC (OR: 1.09, 95% CI: 1.02–1.17, <i>p</i> = 0.009), neutrophil count upon admission (OR: 1.15, 95% CI: 1.04–1.26, <i>p</i> = 0.004), and peak CRP (OR: 1.01, 95% CI: 1–1.01, <i>p</i> = 0.03) predicted LVT formation, which was also evident in multivariate regression models.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusion</h3>\\n \\n <p>WBC and neutrophil counts upon admission, as well as peak WBC and CRP, have additional predictive value for LVT formation following STEMI, beyond classical risk factors.</p>\\n </section>\\n </div>\",\"PeriodicalId\":10201,\"journal\":{\"name\":\"Clinical Cardiology\",\"volume\":\"47 10\",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-10-16\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/clc.70031\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical Cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/clc.70031\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Cardiology","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/clc.70031","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

摘要

背景有关 STEMI（ST 段抬高型心肌梗死）后炎症与早期左心室血栓（LVT）形成之间关系的数据十分有限。本研究旨在探讨几种炎症生物标志物对 STEMI 后左心室血栓形成的预测价值。方法和结果我们的队列包括 2534 名连续入住心脏重症监护病房（CICU）的 STEMI 患者。最终分析结果包括 51 例 LVT 患者和 102 例无 LVT 患者，患者的年龄、性别、前梗死和射血分数均匹配。入院时，LVT 患者的白细胞计数（WBC）较高（12.8 ± 7 vs. 12.4 ± 4 ×103/µL，P = 0.01），中性粒细胞绝对计数较高（10.5 ± 4 vs. 8.6 ± 4 ×103/µL，P = 0.01）。6 ± 4 ×103/µL，p = 0.003）、中性粒细胞与淋巴细胞比率（8.2 ± 6 vs. 4.8 ± 4，p = 0.04）和 C 反应蛋白（CRP）水平（35.9 ± 62 vs. 18.6 ± 40 mg/L，p = 0.04）更高。LVT 组的白细胞和 CRP 峰值也更高（分别为 17.8 ± 8 vs. 14.6 ± 5 ×103/µL, p = 0.003 和 95.8 ± 82 vs. 64.2 ± 76 mg/L, p = 0.02）。在单变量回归分析中，入院时白细胞（OR：1.12，95% CI：1.02-1.21，P = 0.02）、白细胞峰值（OR：1.09，95% CI：1.02-1.17，P = 0.009）、入院时中性粒细胞计数（OR：1.15，95% CI：1.04-1.26，p = 0.004）和 CRP 峰值（OR：1.01，95% CI：1-1.01，p = 0.03）预测 LVT 的形成，这在多变量回归模型中也很明显。结论入院时的白细胞和中性粒细胞计数以及白细胞和 CRP 峰值对 STEMI 后 LVT 的形成具有传统风险因素之外的预测价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

The Role of Inflammation in Early Left Ventricular Thrombus Formation Following ST-Elevation Myocardial Infarction—A Matched Case-Control Study

Background

There is limited data on the association between inflammation and the formation of early left ventricular thrombus (LVT) following ST-elevation myocardial infarction (STEMI). This study aimed to explore the predictive value of several inflammatory biomarkers for LVT formation following STEMI.

Methods and Results

Our cohort included 2534 consecutive patients admitted to the cardiac intensive care unit (CICU) with STEMI. The final analysis included 51 patients with LVT and 102 patients without LVT, matched for age, sex, anterior infarct and ejection fraction. Upon admission, patients with LVT had higher white blood cell counts (WBC) (12.8 ± 7 vs. 12.4 ± 4 ×10³/µL, p = 0.01), higher absolute neutrophil counts (10.5 ± 4 vs. 8.6 ± 4 ×10³/µL, p = 0.003), neutrophil-to-lymphocyte ratio (8.2 ± 6 vs. 4.8 ± 4, p = 0.04), and C-reactive protein (CRP) levels (35.9 ± 62 vs. 18.6 ± 40 mg/L, p = 0.04). Peak values for WBC and CRP were also higher in the LVT group (17.8 ± 8 vs. 14.6 ± 5 ×10³/µL, p = 0.003 and 95.8 ± 82 vs. 64.2 ± 76 mg/L, p = 0.02, respectively). In univariate regression analysis, WBC upon admission (OR: 1.12, 95% CI: 1.02–1.21, p = 0.02), peak WBC (OR: 1.09, 95% CI: 1.02–1.17, p = 0.009), neutrophil count upon admission (OR: 1.15, 95% CI: 1.04–1.26, p = 0.004), and peak CRP (OR: 1.01, 95% CI: 1–1.01, p = 0.03) predicted LVT formation, which was also evident in multivariate regression models.

Conclusion

WBC and neutrophil counts upon admission, as well as peak WBC and CRP, have additional predictive value for LVT formation following STEMI, beyond classical risk factors.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Clinical Cardiology 医学-心血管系统

CiteScore

5.10

自引率

3.70%

发文量

189

审稿时长

4-8 weeks

期刊介绍： Clinical Cardiology provides a fully Gold Open Access forum for the publication of original clinical research, as well as brief reviews of diagnostic and therapeutic issues in cardiovascular medicine and cardiovascular surgery. The journal includes Clinical Investigations, Reviews, free standing editorials and commentaries, and bonus online-only content. The journal also publishes supplements, Expert Panel Discussions, sponsored clinical Reviews, Trial Designs, and Quality and Outcomes.