A Study on Prognostic Significance of White Blood Cell Count and Blood Glucose Levels at Admission in ST Elevation Myocardial Infarction

BACKGROUND AND OBJECTIVE: Admission white blood cell (WBC) count and Random Blood Sugar glucose (RBS) have been associated with adverse outcomes after acute myocardial infarction (AMI). This study investigated the combined effect of WBC count and Random Blood Sugar on predicting in-hospital mortality in patients with acute myocardial infarction. MATERIAL AND METHODS: 80 consecutive patients presenting with acute ST elevation myocardial infarction admitted in IMCU/ICCU Thanjavur Medical College Hospital from January 2014 to August 2014 were studied. Patients satisfied the inclusion criteria underwent detailed history and clinical examination. WBC count and RBS were measured at the time of hospital admission and the patients were stratified into 3 groups (low, medium, and high) based on their WBC count and blood glucose. RESULTS: Patients with a high RBS had a four fold increase in in-hospital mortality and the patients with a high WBC count had a ten fold increase in mortality when compared with those with normal values. When a combination of different strata for each variable was analyzed, a stepwise increase in mortality was seen. Patients with high WBC count and normal RBS level or with a normal WBC count and high RBS values had intermediate risk. Multivariate analysis was performed to assess the predictors for in-hospital mortality using WBC count and RBS level as continuous variables and it showed these two were independently associated with in-hospital mortality. CONCLUSION: W.B.C count and plasma glucose level at admission has a prognostic importance in predicting in-hospital mortality in acute myocardial infarction