Relationship Between Hyperglycemia And Leukocytosis And The Complications Of Early Stage Of Acute Mtocardial Infarction

Objective:Acute myocardial infarction (AMI) is a worldwide public health problem and one of the commonest reason for intensive medical intervention due to its abrupt onset, dangerous course, and high mortality. Therefore, the impact of its short-term prognosis risk factors should be discussed in order to take more effective prevention measures to improve treatment and reduce mortality. There are many factors which can affect short-term prognosis of AMI, including older age, area of myocardial infarction, myocardial enzymes concentrations, ECG ST-segment depre-ssion level, recent cardiac arrhythmia, heart failure, and cardiogenic shock. Particularly, patients with early complications of AMI such as arrhythmia, heart failure, and cardiogenic shock may have poor prognosis. Either stress hyperglycemia or leukocytosis has been confirmed to be associated with advers effects of AMI. This paper aims to explore the relationship between hyperglycemia combining with leukocytosis and the complications of early stage of AMI such as arrhythmia, heart failure, cardiogenic shock.Methods:One hundred and fifty patients with AMI in anterior wall were enrolled from June 2007 to March 2010. The duration of onset ranges no more than 12 hours. Venous blood of all patients were collected to detect white blood cells (WBC) immediately. All patients were performed treatment of percutaneous coronary intervention (PCI) and given routine medicine treatment. Fasting venous blood were collected to detect blood glucose (FBG) next morning after PCI operation. Patients with FBG concentration 3.9-6.0 mmol/L and white blood cells 4-10×109/L were classified as Group 1 (control group); Patients with FBG concentration 6.1-10.0mmol/L were classified as group 2; Patients with WBC count 10.1-15.0×l09/L were classified as group 3; Patients with FBG concentration 6.1-10.0mmol/L combined with WBC count 10.1-15.0×109/L were classified as 4 groups.The patients were monitored closely to observe arrhythmia, heart failure, cardiogenic shock, and treatment strategies as well. All data were analyzed among four groups using a statistical analyzing software.Results:Compared with Group 1, patients in Group 2,3 and 4 had higner incidence of arrhythmia, heart failure, cardiogenic shock (P<0.05). Patients in Group 4 showed the hignest incidence of arrhythmia, heart failure, cardiogenic shock compared with Group 2 and 3 (P<0.05, respectively). There was no statistically significant difference in treatment options and medication among four groups (P>0.05).Conclusion:Patients in early stages of AMI are prone to developing stress hyperglycemia and leukocytosis. Blood glucose concentration and WBC count can be regarded as good predicators for the complications of AMI. It is necessary to monitoring closely blood glucose levels and peripheral blood WBC count so as to reduce arrhythmia, heart failure, cardiogenic shock in AMI patients and to improve prognosis and mortality of patients in early stage of AMI.