White blood cell count on admission as prognostic marker for assessment of severity of acute myocardial infarction


  • Vibhuti Jain Shalby Hospital, Indore, Madhya Pradesh, India
  • Aklesh Kumar Jain Shalby Hospital, Indore, Madhya Pradesh, India




White blood cells, Prognostic markers, Acute myocardial infarction


Background: High white blood cell/leucocyte counts were predicted as important biomarkers for future cardiovascular events in both healthy individuals and are having history myocardial infarction. The aim of the study was to assess the role of leucocytes as predictors of morbidity and mortality during the hospitalization of patients with acute myocardial infarction.

Methods: This was a prospective study conducted on 79 patients with evolving STEMI attending the emergency department of Maharaja Yeshwant Rao Hospital, Indore during the period from November 2004 to July 2005. Blood total leucocyte count (TLC) was done in all the patients. All-cause mortality rate during the follow up period was defined as the primary end point of the study. Composite of death, reinfarction and heart failure till follow up day were defined as the secondary outcomes.

Results: The mean age of the patients was 55.9±10.4 years. Male dominance was (86%) seen in the study. The mean TLC in the study population was 12345±4922/cumm. A total of 16 (20.2%) patients were died during 3 months of follow up. Statistically significant difference (p<0.001) was seen for characteristics such as age, risk index score, mean blood pressure heart rate and the Kilip class between survivors and non-survivors. The mean difference of TLC and mean CKMB was greater in non-survivors compared to survivors but the difference was not significant (p=0.177). Age, risk index, Kilip class, serum creatinine and baseline TLC, was found to affect the occurrence of the events significantly with a p value of less than 0.05.

Conclusions: The findings conclude that the high blood leucocyte count was proved to be an important prognostic factor for assessing the severity of acute myocardial infarction in study population.


Cassar A, Holmes DR Jr, Rihal CS, Gersh BJ. Chronic coronary artery disease: diagnosis and management. Mayo Clin Proc. 2009;84(12):1130-46.

Fuster V, Stein B, Ambrose JA, Badimon L, Badimon JJ, Chesebro JH. Atherosclerotic plaque rupture and thrombosis. Evolving concepts. Circulation. 1990;82(3):47-59.

Melero-Ferrer JL, López-Vilella R, Morillas-Climent H, Sanz-Sánchez J, Sánchez-Lázaro IJ, Almenar-Bonet L, et al. Novel Imaging Techniques for Heart Failure. Card Fail Rev. 2016;2(1):27-34.

Khuseyinova N, Koenig W. Biomarkers of outcome from cardiovascular disease. Curr Opin Crit Care. 2006;12(5):412–9.

Madjid M, Awan I, Willerson JT, Casscells SW. Leukocyte count and coronary heart disease: implications for risk assessment. J Am Coll Cardiol. 2004;44(10):1945–56.

Brown DW, Giles WH, Croft JB. White blood cell count: an independent predictor of coronary heart disease mortality among a national cohort. J Clin Epidemiol. 2001;54(3):316–22.

Takeda Y, Suzuki S, Fukutomi T, Kondo H, Sugiura M, Suzumura H, et al. Elevated white blood cell count as a risk factor of coronary artery disease: inconsistency between forms of the disease. JPN Heart J. 2003;44(2):201–11.

Barron HV, Harr SD, Radford MJ, Wang Y, Krumholz HM. The association between white blood cell count and acute myocardial infarction mortality in patients > or = 65 years of age: findings from the cooperative cardiovascular project. J Am Coll Cardiol. 2001;38(6):1654–61.

Mueller C, Neumann FJ, Perruchoud AP, Buettner HJ. White blood cell count and long term mortality after non-ST elevation acute coronary syndrome treated with very early revascularisation. Heart. 2003;89(4):389–92.

Djurdjevic PM, Arsenijevic NN, Baskic DD, Djukic AL, Popovic S, Samardzic G. Systemic response of peripheral blood leukocytes and their phagocytic activity during acute myocardial infarction. Exp Clin Cardiol. 2001;6(3):159-66.

Bae MH, Lee JH, Yang DH, Park HS, Cho Y, Chae SC. White blood cell, hemoglobin and platelet distribution width as short-term prognostic markers in patients with acute myocardial infarction. J Korean Med Sci. 2014;29(4):519-26.

Madjid M, Awan I, Willerson JT, Casscells SW. Leukocyte count and coronary heart disease: implications for risk assessment. J Am Coll Cardiol. 2004;44(10):1945–56.

Neumann FJ, Ott I, Marx N, Luther T, Kenngott S, Gawaz M, et al. Effect of human recombinant interleukin-6 and interleukin-8 on monocyte procoagulant activity. Arterioscler Thromb Vasc Biol. 1997;17(12):3399–405.

Bovill EG, Bild DE, Heiss G, Kuller LH, Lee MH, Rock R, et al. White blood cell counts in persons aged 65 years or more from the Cardiovascular Health Study. Correlations with baseline clinical and demographic characteristics. Am J Epidemiol. 1996;143(11):1107–15.

de Gaetano G, Cerletti C, Evangelista V. Recent advances in platelet-polymorphonuclear leukocyte interaction. Haemostasis. 1999;29(1):41–9.

Morange P E, Simon C, Alessi M C. et al. Endothelial cell markers and the risk of coronary heart disease: the Prospective Epidemiological Study of Myocardial Infarction (PRIME) study. Circulation. 2004;109(11):1343–8.

Granger CB, Goldberg R J, Dabbous O, Pieper KS, Eagle KA, Cannon CP, et al. Predictors of hospital mortality in the global registry of acute coronary events. Arch Intern Med. 2003;163(19):2345–53.

Dharma S, Hapsari R, Siswanto BB, van der Laarse A, Jukema JW. Blood Leukocyte Count on Admission Predicts Cardiovascular Events in Patients with Acute Non-ST Elevation Myocardial Infarction. Int J Angiol. 2015;24(2):127-32.

Grzybowski M, Welch RD, Parsons L, Ndumele CE, Chen E, Zalenski R, Barron HV. The association between white blood cell count and acute myocardial infarction in-hospital mortality: findings from the National Registry of Myocardial Infarction. Acad Emerg Med. 2004;11:1049-60.






Original Research Articles