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The Role of White Blood Cells inAcute Coronary Syndrome

Author: Hilal B. Shawki )
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 / 24108057 Year: 2007 Volume: 49 Issue: 4 Pages: 362-368
Publisher: Baghdad University جامعة بغداد


Inflammation has been shown to play a role in atherosclerosis and acute coronary
syndromes. An elevated total WBC count has been associated with increased cardiovascular
risk, but which leukocyte subtypes carry this risk. is uncertain. This study was designed to
determine the effect of WBC count and other inflammatory markers on severity and
outcome of patients with UA/NSTEMI.
Patients and Methods:
Seventy (70) patients with UA / NSTEMI admitted to CCU at the Iraqi Center for Heart
Diseases were subjected to thorough history and physical examination and WBC indices to
find their relation to clinical severity and outcome for both in-hospital and/month after
discharge. The results were compared with other thirty (30) patients with chronic stable
angina and thirty (30) healthy persons as two control groups.
Fac Med Baghdad
2007; Vol.49, No.4
Received Sept. 2006
Accepted Oct .2007
High total baseline total WBC was more prevalent in patient with UA/NSTEMI than in
those with stable angina and normal persons (94.1%, 5.9%. and 0%) respectively. High
baseline neutrophil was found only in those with UA./NSTEMI (100%, 0%, and 0%). High
baseline Neutrophil/lymphocyte (N/L ratio) and Positive CRP were more prevalent in
patients with UA/NSTEMI than in other two groups (92.3%. 7.7%. 0%) and (98.5%, 1 .5%.
0%) respectively.
Higher total baseline WBC count was significantly found in more severe Braunwald's
class of those with UA/NSTEMI 6.3%. 31.3%. and 50.5% for patients with class I, II, III
respectively. The same was true for baseline high neutrophil count (6.7%. 33.3% to 60%),
high Baseline N/L ratio (7.7%, 15%. and 21.6%).
Patient in the UA/NSTEMI group with higher baseline WBC count had higher risk for
death as compared to those of low and intermediate WBC count (0.00%. 0.00%. and
100.00%). The same was true for those with higher baseline neutrophil count (0.00%.
1.90%, 20.00%) and those with higher baseline N/L ratio (0.00%. 25.000%. 75.000%)
Total baseline WBC and differential count is simple, cheap and widely available
bedside test that predicted the severity of CAD and one month survival.


WBC count --- differential count --- CRP --- UA/NSTEMI

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