Key result
A delta neutrophil index greater than 2.5% within 2 hours of primary percutaneous coronary intervention was associated with a significantly increased risk of 30-day mortality (HR 13.643).
Why the study?
Does an elevated delta neutrophil index predict 30-day mortality in patients with STEMI undergoing primary PCI?
Cohort (n=842)
No
Does an elevated delta neutrophil index predict 30-day mortality in patients with STEMI undergoing primary PCI?
Hazard Ratio: 13.643 (95% CI 8.13–22.897)
p-value: p=<0.001
An elevated delta neutrophil index measured within 24 hours of primary PCI is a strong independent predictor of 30-day mortality in patients with STEMI.
Should not yet guide STEMI risk stratification after primary PCI; leaves open prospective validation of delta neutrophil index utility.
This study aimed to evaluate the association between the delta neutrophil index (DNI), which reflects immature granulocytes, and the severity of ST-elevation myocardial infarction (STEMI), as well as to determine the significance of the DNI as a prognostic marker for early mortality and other clinical outcomes in patients with STEMI who underwent reperfusion. This retrospective, observational cohort study was conducted using patients prospectively integrated in a critical pathway program for STEMI. We included 842 patients diagnosed with STEMI who underwent primary percutaneous coronary intervention (pPCI). Higher DNI values at time-I (within 2 h of pPCI; hazard ratio [HR], 1.075; 95% confidence interval [CI]: 1.046-1.108; p < 0.001) and time-24 (24 h after admission; HR, 1.066; 95% CI: 1.045-1.086; p < 0.001) were significant independent risk factors for 30-day mortality. Specifically, DNI values >2.5% at time-I (HR, 13.643; 95% CI: 8.13-22.897; p < 0.001) and > 2.9% at time-24 (HR, 12.752; 95% CI: 7.308-22.252; p < 0.001) associated with increased risks of 30-day mortality. In conclusion, an increased DNI value, which reflects the proportion of circulating immature granulocytes in the blood, was found to be an independent predictor of 30-day mortality and poor clinical outcomes in patients with acute STEMI post-pPCI.
No takes yet. Share an insight, caveat, or question.
Kong et al. (2017) conducted a cohort in ST segment elevation myocardial infarction (STEMI) (n=842). Delta neutrophil index (DNI) > 2.5% within 2 hours of pPCI vs. DNI ≤ 2.5% was evaluated on 30-day mortality (HR 13.643, 95% CI 8.13-22.897, p=<0.001). A delta neutrophil index greater than 2.5% within 2 hours of primary percutaneous coronary intervention was associated with a significantly increased risk of 30-day mortality (HR 13.643).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: