You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

Low lymphocyte count in acute phase of ST-segment elevation myocardial infarction predicts long-term recurrent myocardial infarction

Núñez, Julioa; Núñez, Eduardoa; Bodí, Vicenta; Sanchis, Juana; Mainar, Luisb; Miñana, Gemaa; Fácila, Lorenzoc; Bertomeu, Vicented; Merlos, Pilara; Darmofal, Helenea; Palau, Patriciaa; Llácer, Angela

Coronary Artery Disease:
doi: 10.1097/MCA.0b013e328332ee15
Pathophysiology and Natural History

Objective: We sought to determine the relationship between the lowest lymphocyte count (lymphocytemin) obtained within the first 96 h of symptoms onset and the risk of postdischarge recurrent spontaneous myocardial infarction (re-MI) in patients admitted with ST-segment elevation MI (STEMI).

Methods: We analyzed 549 consecutive patients admitted with STEMI from a single academic hospital. Lymphocyte counts were determined at admission and routinely during the first 96 h. Lymphocytemin was selected as the main exposure. Patients with inflammatory or infectious diseases, in-hospital death, or reinfarction were excluded from the analysis (final sample=426 patients). Lymphocytemin was divided into quartiles (Q) and their association with re-MI was assessed by competing risk analysis. Postdischarge death and coronary revascularization were considered competing events.

Results: During a median follow-up of 36 months, 53 re-MI (12.4%) were registered. The re-MI crude rate was significantly higher in patients in the lowest lymphocytemin quartile (Q1≤1045 cells/ml) compared with Q2–Q4: 22.4, 9.4, 8.4, 9.4%, respectively; P=0.005. In a multivariate setting, Q1 was also associated with a significant increased risk of re-MI compared with Q2–Q4 (hazard ratio: 2.04, 95% confidence interval: 1.11–3.76; P=0.021).

Conclusion: Low lymphocyte count obtained within the first 96 h of a STEMI predicts the risk of re-MI.

Author Information

aServicio de Cardiología, Hospital Clínico Universitario, Universitat de Valencia, Valencia-España

bHospital de Requena, Valencia-España

cServicio de Cardiología, Hospital Provincial de Castellón, Castellón-España

dServicio de Cardiología, Hospital Universitario de San Juan, Alicante-España, Spain

Correspondence to Julio Núñez, MD, Servicio de Cardiología, Hospital Clínico Universitario, Avda, Blasco Ibáñez 17, 46010 Valencia-España, Spain

Tel: +1 34 65 285 6689; fax: +1 34 96 386 2658;


Received 18 June 2009 Revised 11 August 2009 Accepted 1 September 2009

© 2010 Lippincott Williams & Wilkins, Inc.