In the setting of an acute myocardial infarction (AMI), elevated white blood cell count (WBC-C) has been associated with adverse cardiovascular events^1–3 implying not only a purely reparative physiological role, but a pathologic one. Therefore, WBC-C has recently drawn the attention of researchers as a potential stratification tool because of its simplicity, cost effectiveness, and wide availability. The present study was designed to determine the independent predictive value of WBC-C on mortality at 30 days and one year after ST segment elevation acute myocardial infarction (STEMI).

METHODS

We studied a cohort of 515 consecutive patients admitted to our centre with STEMI from October 2000 to February 2003. STEMI was defined based on the criteria established by the American College of Cardiology and European Society of Cardiology. Total WBC-C (× 10⁹/l) was obtained in the emergency department within the first 24 hours of symptom onset. The treatment allocated to each patient, was individualised following established guidelines. The decision for surgical or percutaneous revascularisation was guided by the presence of ominous symptoms, like recurrent angina, severe heart failure, or a positive stress test at discharge. Death for any cause was selected as a main end point and ascertained either during hospitalisation, …