Document Type : Original Article
Authors
- Mahtab Mashayekhi 1
- Mahdokht Rezaei 1
- Abbas Allami 1
- Narges Bazgir 2
- Monirsadat Mirzadeh 3
- Shahin Aliakbari 1
- Kimia Rahimi Ardali 1
1 Boali Hospital, Qazvin University of Medical Sciences, Qazvin, Iran
2 Hearing Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Department of Community Medicine, Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
Abstract
BACKGROUND: ST-segment elevation myocardial infarction (STEMI) results from coronary artery blockage due to ruptured atherosclerotic plaque. Eosinophils play a dual role in STEMI, contributing to thrombus formation and tissue repair. This study investigates the association between eosinophil percentage, platelet counts, and in-hospital prognosis in STEMI patients.
METHODS: A cross-sectional study was conducted from September 2019 to February 2020, including patients aged 18 and above with a STEMI diagnosis. In-hospital mortality, arrhythmia, and left ventricular ejection fraction (LVEF) were recorded. Demographic data, clinical manifestations, and laboratory investigations were collected. Data were analyzed using SPSS (version 25.0), with a P value of <0.05 considered significant.
RESULTS: The study included 100 STEMI patients with a mean age of 65±13.26 years; 75% were male. The mortality rate was 13%. A significant relationship was found between eosinophil percentage and mortality (p=0.032), and platelet count also correlated significantly with mortality (p=0.008). The association between eosinophil percentage and EF was significant (p<0.001). The area under the ROC curve was 0.705 (95% CI 0.605 - 0.792) for platelet counts and 0.679 (95% CI 0.577 - 0.770) for eosinophil percentage in differentiating live and expired patients.
CONCLUSION: Platelet count could be a significant prognostic indicator for in-hospital outcomes in STEMI patients, suggesting an increased risk of mortality. Additionally, there is a notable relationship between eosinophil percentage and ejection fraction (EF).
Keywords
2. Bates ER, Jacobs AK. Time to treatment in patients with STEMI. N Engl J Med. 2013 Sep 5;369(10):889-92. https://doi.org/10.1056/nejmp1308772
3. Ahuja KR, Saad AM, Nazir S, Ariss RW, Shekhar S, Isogai T, et al. Trends in Clinical Characteristics and Outcomes in ST-Elevation Myocardial Infarction Hospitalizations in the United States, 2002-2016. Curr Probl Cardiol. 2022 Dec;47(12):101005. https://doi.org/10.1016/j.cpcardiol.2021.101005
4. Ramirez GA, Yacoub MR, Ripa M, Mannina D, Cariddi A, Saporiti N, et al. Eosinophils from Physiology to Disease: A Comprehensive Review. Biomed Res Int. 2018 Jan 28;2018:9095275. https://doi.org/10.1155/2018/9095275
5. Güner A, Zehİr R, KalçIk M, Uslu A, Ösken A, Kalkan AK, et al. Eosinophil percentage as a new prognostic marker in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Interv Med Appl Sci. 2019 Oct 7;11(3):146-53. https://doi.org/10.1556/1646.11.2019.17
6. Sincer I, Gunes Y, Mansiroglu AK, Aktas G. Differential value of eosinophil count in acute coronary syndrome among elderly patients. Aging Male. 2020 Dec;23(5):958-61. https://doi.org/10.1080/13685538.2019.1643310
7. Ye L, Bai HM, Jiang D, He B, Wen XS, Ge P, et al. Combination of eosinophil percentage and high-sensitivity C-reactive protein predicts in-hospital major adverse cardiac events in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. J Clin Lab Anal. 2020 Sep;34(9):e23367. https://doi.org/10.1002/jcla.23367
8. Toor IS, Rückerl D, Mair I, Ainsworth R, Meloni M, Spiroski AM, et al. Eosinophil Deficiency Promotes Aberrant Repair and Adverse Remodeling Following Acute Myocardial Infarction. JACC Basic Transl Sci. 2020 Jul 8;5(7):665-81. https://doi.org/10.1016/j.jacbts.2020.05.005
9. Packham MA. Role of platelets in thrombosis and hemostasis. Can J Physiol Pharmacol. 1994 Mar;72(3):278-84. https://doi.org/10.1139/y94-043
10. Turner SJ, Ketch TR, Gandhi SK, Sane DC. Routine hematologic clinical tests as prognostic markers in patients with acute coronary syndromes. Am Heart J. 2008 May;155(5):806-16. https://doi.org/10.1016/j.ahj.2007.11.037
11. Paul GK, Sen B, Bari MA, Rahman Z, Jamal F, Bari MS, et al. Correlation of platelet count and acute ST-elevation in myocardial infarction. Mymensingh Med J. 2010 Jul;19(3):469-73.
12. Kurtul A, Yarlioglues M, Murat SN, Ergun G, Duran M, Kasapkara HA, et al. Usefulness of the platelet-to-lymphocyte ratio in predicting angiographic reflow after primary percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction. Am J Cardiol. 2014 Aug 1;114(3):342-7. https://doi.org/10.1016/j.amjcard.2014.04.045
13. Sharif D, Abu-Salem M, Sharif-Rasslan A, Rosenschein U. Platelet counts on admission affect coronary flow, myocardial perfusion and left ventricular systolic function after primary percutaneous coronary intervention. Eur Heart J Acute Cardiovasc Care. 2017 Oct;6(7):632-9. https://doi.org/10.1177/2048872616643690
14. Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD. Third universal definition of myocardial infarction. circulation. 2012;126(16):2020-35. https://doi.org/10.1161/CIR.0b013e31826e1058
15. Liu J, Yang C, Liu T, Deng Z, Fang W, Zhang X, et al. Eosinophils improve cardiac function after myocardial infarction. Nat Commun. 2020;11(1):6396. https://doi.org/10.1038/s41467-020-19297-5
16. Rios-Navarro C, Gavara J, Vidal V, Bonanad C, Racugno P, Bayes-Genis A, et al. Characterization and implications of the dynamics of eosinophils in blood and in the infarcted myocardium after coronary reperfusion. PLoS One. 2018 Oct 26;13(10):e0206344. https://doi.org/10.1371/journal.pone.0206344
17. Wen T, Rothenberg ME. The Regulatory Function of Eosinophils. Microbiol Spectr. 2016 Oct;4(5):10.1128/microbiolspec.MCHD-0020-2015. https://doi.org/10.1128/microbiolspec.mchd-0020-2015
18. Isobe Y, Kato T, Arita M. Emerging roles of eosinophils and eosinophil-derived lipid mediators in the resolution of inflammation. Front Immunol. 2012 Aug 28;3:270. https://doi.org/10.3389/fimmu.2012.00270
19. Atkinson JB, Robinowitz M, McAllister HA, Virmani R. Association of eosinophils with cardiac rupture. Hum Pathol. 1985 Jun;16(6):562-8. https://doi.org/10.1016/s0046-8177(85)80105-2
20. Bass DA. Behavior of eosinophil leukocytes in acute inflammation. II. Eosinophil dynamics during acute inflammation. J Clin Invest. 1975 Oct;56(4):870-9. https://doi.org/10.1172/jci108166
21. Frangogiannis NG. The inflammatory response in myocardial injury, repair, and remodelling. Nat Rev Cardiol. 2014 May;11(5):255-65. https://doi.org/10.1038/nrcardio.2014.28
22. Xu JY, Xiong YY, Tang RJ, Jiang WY, Ning Y, Gong ZT, et al. Interleukin-5-induced eosinophil population improves cardiac function after myocardial infarction. Cardiovasc Res. 2022 Jul 20;118(9):2165-78. https://doi.org/10.1093/cvr/cvab237
23. Jiang P, Wang DZ, Ren YL, Cai JP, Chen BX. Significance of eosinophil accumulation in the thrombus and decrease in peripheral blood in patients with acute coronary syndrome. Coron Artery Dis. 2015 Mar;26(2):101-6. https://doi.org/10.1097/mca.0000000000000186
24. Firani NK, Hartanti KD, Purnamasari P. Hematological Parameter as Predictor Mortality in Acute Myocardial Infarction Patients. Int J Gen Med. 2022 Aug 23;15:6757-63. https://doi.org/10.2147/ijgm.s380659
25. Konishi T, Funayama N, Yamamoto T, Morita T, Hotta D, Nishihara H, et al. Prognostic Value of Eosinophil to Leukocyte Ratio in Patients with ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention. J Atheroscler Thromb. 2017 Aug 1;24(8):827-40. https://doi.org/10.5551/jat.37937
26. Alkhalil M, Kearney A, Hegarty M, Stewart C, Devlin P, Owens CG, et al. Eosinopenia as an Adverse Marker of Clinical Outcomes in Patients Presenting with Acute Myocardial Infarction. Am J Med. 2019 Dec;132(12):e827-34. https://doi.org/10.1016/j.amjmed.2019.05.021
27. Zhao X, Jiang L, Xu L, Tian J, Xu Y, Zhao Y, et al. Predictive value of in-hospital white blood cell count in Chinese patients with triple-vessel coronary disease. Eur J Prev Cardiol. 2019 May;26(8):872-82. https://doi.org/10.1177/2047487319826398
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