Neutrophil Count on Admission Predicts Major In‐hospital Events in Patients with a Non‐ST‐Segment Elevation Acute Coronary Syndrome

Background Inflammation plays a key role in the pathogenesis of acute coronary syndromes (ACS). In this context we assessed neutrophil count as a predictor of major in‐hospital events in patients admitted for a non‐ST‐segment elevation (NSTE) ACS. Methods We measured neutrophils on admission in 160 patients with a NSTE ACS and we correlated their count with the incidence of a combined in‐hospital end point including: cardiac death, acute heart failure, ST‐segment elevation myocardial infarction, and recurrent myocardial ischemia. Results Patients who had a major in‐hospital event also had a higher neutrophil count ( P = 0.02) and higher serum levels of troponin I ( P = 0.04). In the univariate logistic regression analysis, in‐hospital major events could be predicted by troponin I > 0.07 ng/mL (odds ratio [OR]: 5.65, 95% confidence interval [CI]: 1.26–25.32, P = 0.02), white blood cell count > 8650 cells/µL (OR: 2.68, 95% CI: 1.03–6.95, P = 0.04), neutrophil count > 6700 cells/µL (OR: 7.74, 95% CI: 2.79–21.47, P < 0.001), and C‐reactive protein > 0.97 mg/dL (OR: 3.56, 95% CI: 1.13–11.19, P = 0.02). However, in multivariate regression, neutrophil count > 6700 cells/µL (OR: 6.52, 95% CI: 1.56–27.22, P = 0.01) was the only independent in‐hospital prognostic factor. Conclusions In patients with a NSTE ACS of moderate or high risk, neutrophil count on admission may identify those who are at risk of having an adverse in‐hospital outcome. Copyright © 2009 Wiley Periodicals, Inc.