Elevated peripheral blood mononuclear cell count is an independent predictor of left ventricular remodeling in patents with acute myocardial infarction

Objectives: Peripheral blood mononuclear cells (PBMCs) increase after acute myocardial infarction (AMI) and infiltrate to the infarct region. However, its impact on left ventricular (LV) remodeling remains unclear. The purpose of the present study was to clarify whether elevated PBMC count contributed to LV remodeling in patients with AMI. Subjects and methods: A total of 131 patients with AMI were recruited. White blood cell (WBC), monocyte, and lymphocyte counts were measured at presentation and every 24 h for five days after presentation. The correlation between PBMC count and LV remodeling was evaluated. LV remodeling was defined as an increase of LV end-diastolic volume index >= 10% at the 6-month follow-up left ventriculography. Results: Forty-eight patients had LV remodeling. Peak WBC (p=0.008), peak monocyte (p=0.001), and peak PBMC (p<0.001) counts were significantly greater in patients with LV remodeling than those without remodeling. Multivariate analysis revealed the peak PBMC count >= 3600/mm(3) was an independent predictor of LV remodeling [relative risk (RR) 3.243, p=0.011]. Conclusion: Increased PBMC count is significantly correlated with LV remodeling, thus suggesting that PBMCs play a pivotal role for the development of LV remodeling after AMI. (C) 2011 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.