The Correlation Between White Blood Cell Count And Very Late Stent Thrombosis After Percutaneous Coronary Intervention

IVObjective:To investigate the correlation between white blood cell count and very late stent thrombosis(VLST)after Percutaneous Coronary Intervention(PCI).Methods:A total of 8565 patients treated with PCI from January 1,2014 to December 31,2018 were enrolled from the Cardiovascular Center Database of the First Hospital of Jilin University.Among them,135 patients with VLST were selected as cases,405 patients were chosen as controls matching with the cases according to sex and age(1:3).After retrospectively analyzing the clinical data of the cases and the controls,we futher investigated the correlation between white blood cell count and very late stent thrombosis using univariate analysis methods(t test,Mann-Whitney U test,?2test),Multivariate logistic regression and ROC curve analysis.Result:A total of 135 patients with VLST occurred in this study,with an incidence of1.57%,including 103 males(76.3%),with a median age of 62 years.Univariate analyses(t test,Mann-Whitney U test,?2 test)revealed that the cases were significantly different from the controls in diabetes mellitus(P=0.027),ejection fraction(P<0.001),preoperative white blood cell(WBC)count(P<0.001),postoperative white blood cell count(P<0.001),and blood glucose(P=0.017).Multivariate logistic regression analysis confirmed that preoperative WBC count(OR=1.146,95%CI:1.055–1.244,P=0.001)and postoperative WBC count(OR=1.130,95%CI: 1.034–1.235,P=0.007)are independent risk factors for VLST after PCI..The results of ROC curve analysis showed that the area under the curve(AUC)ofpreoperative white blood cell count to predict the occurrence of VLST after PCI was0.723(95% CI: 0.0.661-0.769(P < 0.001).When the cut-off point of preoperative white blood cell count(the best critical value)was taken as 10.02 x1012/L,the sensitivity and specificity for predicting the occurrence of VLST were 0.622 and0.783,respectively.One month after operation,the area under the curve of white blood cell count to predict the occurrence of VLST after PCI was 0.657(95% CI:0.0.604-0.711(P < 0.001).When the cut-off point of white blood cell count was taken as 8.38 x1012/L,the sensitivity and specificity for predicting the occurrence of VLST were 0.514 and 0.715 respectively.Conclusion:1.The incidence of VLST was 1.57%.2.Preoperative white blood cell count and Postoperative white blood cell count are independent risk factors for VLST after PCI.3.Preoperative white blood cell count and Postoperative white blood cell count have good predictive value for the occurrence of VLST,but white blood cell count before operation is more valuable for predicting the occurrence of VLST.