Waseem Ahmad, Muhammad Zahid Ali Raza, Uzma Sajjad.
The positive predictive value of absolute neutrophilia for development of early congestive heart failure in patients of acute myocardial infarction.
J Cardiovascular Dis Jan ;12(2):37-41.

BACKGROUND:Leukocytosis and neutrophilia is associated with post MI mortality and Heart Failure. The presence of absolute neutrophilia during first 12 hours after AMI can predict the occurrence of CHF which may help to identify high risk individuals who can then be benefited from more aggressive treatment OBJECTIVE:To determine the positive predictive value of absolute neutrophilia for development of early congestive heart failure in patients of acute myocardial infarction METHODS:This was a cross sectional study conducted at Department of Cardiology Mayo hospital Lahore from November 2013 to April 2014. A total of 260 patients were included in the study after their informed consent. Demographic data (name, age, gender, weight, height) was noted. Information about history of smoking, hypertension and diabetes was taken and blood was drawn at admission to determine absolute neutrophil counts. Patients were divided into two groups on the basis of raised or normal absolute neutrophil count (ANC) values. Echocardiography was done 4 days after admission to determine ejection fraction and label early CHF as per operational definitions. All patients were managed according to standard protocol for acute MI. Data entry and analysis was done by using SPSS 13. RESULTS:Mean age of all these 260 patient was 52.12±8.86 years. Gender distribution of patients showed that there were 120 female and 140 male patients. 86(33%) patients were diabetic, 82(32%) were hypertensive and 37% were smokers. In 184(70%) patients, absolute neutrophilia was observed. Heart failure was observed in 128(69%) of these patients. The positive predictive value for absolute neutrophilia turns out to be 69.57%. CONCLUSION : Positive predictive value for absolute neutrophilia is high for heart failure in these patients. KEY WORDS:A bsolute neutrophilia, Early congestive heart failure, Acute myocardial infarction

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