Abstract 2489: Early Risk Stratification in Patients Treated with Primary PCI for STEMI Based on the Simultaneous Assessment of Admission WBC Count and Levels of Glycemia and Creatinine
WBC count, glucose and creatynine measured on admission each predict adverse event in patients with STEMI. However, value of an early risk stratification upon the simultaneous assessment of this biomarkers is unknown.
Methods. In 1662 consecutive pts (70.4% male, 60.2±11.8 yrs) WBC count, glucose and creatinine levels were measured on admission. Elevation of each biomarker was judged upon the established cut-off points: 11.1 mmol/L for admission glucose, 1.2 mg/dl for creatynine and based on the ROC analysis: WBC count of 14.3x103/L. Pts were categorized into the 4 groups accordingly to the number of elevated biomarkers.
Results. Overall in-hospital mortality was 5.2%. Pts admitted with elevated WBC count (21.4%) had higher mortality (10.4% vs. 3.8%, p<0.001). Pts with hyperglycemia (19.8%) died more often (15.8% vs. 2.6%, p<0.001). Similarly, higher mortality rate was noted in pts (20.5%) with increased creatynine (12.6% vs. 3.3%, p<0.001). In a multivariate analysis all biomarkers were independent predictors of mortality. Significant increase in the mortality for each additional biomarker that was elevated was present (p<0.001, Table⇓).
Conclusions. WBC count, glycemia and creatinine levels on admission each provides prognostic information in pts treated with primary PCI for STEMI. Simple risk stratification based on numbers of routinely assessed markers allows early identification of subjects with very low versus those of exceptionally high in- hospital mortality.