Yerra, Shivakumar (2007) High-Sensitivity C-reactive Protein, Leukocyte and Differential Count in patients with Acute Myocardial Infarction Introduction. Masters thesis, Christian Medical College, Vellore.
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Abstract
INTRODUCTION : Coronary artery disease remains the leading cause of serious morbidity and mortality in adults. Although standard risk factors account for most of the risk profile in the population, they do not explain the picture in its entirety. Half of all myocardial infarctions occur in persons in whom plasma lipid levels are normal. The advancement in the understanding of pathophysiology of atherosclerotic vascular disease have thrown new insights regarding potential indicators of underlying atherosclerosis and cardiovascular risk. Due to absence of usual clinical symptoms, detection of preclinical atherosclerosis in patients is a challenging job. The development of an atherosclerotic plaque involves a complex interaction between the endothelium, inflammatory cytokines and various blood elements (Figure 1, 2). In an effort to identify patients at high risk for cardiovascular events, several novel risk markers have been proposed for use in screening. Inflammation is thought to play a key role in the pathogenesis of coronary artery disease. C-reactive protein (CRP), a marker for inflammation, is a prognostic marker for stable angina pectoris, unstable angina and non-Q wave myocardial infarction. AIM : To assess the association of high sensitivity C-reactive protein and white cell count to inhospital complications of STEMI. OBJECTIVES : 1. To evaluate the prognostic value of CRP measured as high sensitivity Creactive protein assay (hs-CRP) in patients with ST segment elevation myocardial infarction. 2. To investigate the relationship between total and differential WBC count obtained on admission with parameters such as LV systolic function and the development of post MI complications during the hospital course. CONCLUSION : 1. In patients presenting with acute ST segment elevation myocardial infarction, elevated hs-CRP level was associated with significant in- hospital complications (odds ratio = 5.2 [95% CI:2.0-13.7] ). 2. The neutrophil and lymphocyte counts individually were also found to have a significant correlation with post MI complications. By the ROC curve, the ideal cut off point for total WBC count to predict post MI adverse events was found to be 12,950 cells/mm3 with sensitivity of 73.5% and specificity of 63.9%. The best cut off point for the absolute neutrophil count to predict post MI complications was 9,720 cells/mm3 with sensitivity of 65.2% and specificity of 69.4%. 3. Our results suggest that hs-CRP level and white cell count obtained at admission in acute ST segment elevation myocardial infarction can be used as a marker for identification of patients who are likely to develop significant complications in the hospital course.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | High-Sensitivity ; C-reactive Protein, Leukocyte ; Differential Count ; patients ; Acute Myocardial Infarction Introduction. |
| Subjects: | MEDICAL > Cardiology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 10 Jul 2017 22:10 |
| Last Modified: | 10 Jul 2017 22:10 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1346 |
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