The prognostic significance of peripheral monocytosis on admission in patients with acute myocardial infarction

Background : The inan important feature of atherosclerotic lesions, and peripheral monocytosis is known to be associated with increased coronary events and poor prognosis in acute myocardial infarction (AMI). The aim of this study was to determine the significance in clinical and angiographic outcomes, success rate of the percutaneous coronary intervention (PCI) and major adverse cardiac events and event-free survival rate after PCI according to the value of peripheral monocyte on admission. Methods : A total of 127 patients with AMI who underwent PCI between June 2000 and June 2001 at Chonnam National University Hospital were divided into two groups: Group I (n=63, 61.7 10.9 years, male 71.4%) with normal monocyte count (, mean alue=536202/) on admission and Group II (n=64, 61.713.4 years, male 78.1%) with elevated monocyte count ( 900/, mean alue=1,140260/) on admission. Results : Baseline ejection fraction was lower in Group II than in Group I (Group I; 53.313.0% vs Group II; 45.011.7%, p=0.014). The value of C-reactive protein, troponin-T and troponin-I was higher in Group II than in Group I (Group I; 2.81.9 mg/dL, 1.981.53 ng/mL, 18.317.7 ng/mL vs Group II; 5.35.0 mg/dL, 3.342.54 ng/mL, 43.124.0 ng/mL, p=0.034, 0.020, 0.006, respectively). The incidence of target lesion revascularization was higher in Group II than in Group I during hospitalization and during 6-month clinical follow-up after PCI (1.6% vs 12.5%, 19.0% vs 31.3%, p=0.012, 0.015, respectively). The event-free survival rates were lower in Group II than in Group I during hospitalization and during 6-month follow-up after PCI (96.8% vs 84.4%, 71.4% vs 53.1%,p=0.006, 0.008, respectively). Conclusion : Peripheral monocytosis is associated with LV dysfunction and higher incidence of target lesion revascularization and worse mid-term event-free survival during hospitalization and at 6 months after PCI in patients with AMI.