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      Eosinophil percentage and platelet counts: Association with in-hospital mortality in ST-segment elevated myocardial infarction

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          Abstract

          BACKGROUND:

          ST-segment elevation myocardial infarction (STEMI) results from coronary artery blockage due to ruptured atherosclerotic plaque. Eosinophils play a dual role in STEMI, contributing to thrombus formation and tissue repair. This study investigates the association between eosinophil percentage, platelet counts, and in-hospital prognosis in STEMI patients.

          METHODS:

          A cross-sectional study was conducted from September 2019 to February 2020, including patients aged 18 and above with a STEMI diagnosis. In-hospital mortality, arrhythmia, and left ventricular ejection fraction (LVEF) were recorded. Demographic data, clinical manifestations, and laboratory investigations were collected. Data were analyzed using SPSS (version 25.0), with a P value of <0.05 considered significant.

          RESULTS:

          The study included 100 STEMI patients with a mean age of 65±13.26 years; 75% were male. The mortality rate was 13%. A significant relationship was found between eosinophil percentage and mortality (p=0.032), and platelet count also correlated significantly with mortality (p=0.008). The association between eosinophil percentage and EF was significant (p<0.001). The area under the ROC curve was 0.705 (95% CI 0.605 - 0.792) for platelet counts and 0.679 (95% CI 0.577 - 0.770) for eosinophil percentage in differentiating live and expired patients.

          CONCLUSION:

          Platelet count could be a significant prognostic indicator for in-hospital outcomes in STEMI patients, suggesting an increased risk of mortality. Additionally, there is a notable relationship between eosinophil percentage and ejection fraction (EF).

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          Most cited references27

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          The inflammatory response in myocardial injury, repair, and remodelling.

          Myocardial infarction triggers an intense inflammatory response that is essential for cardiac repair, but which is also implicated in the pathogenesis of postinfarction remodelling and heart failure. Signals in the infarcted myocardium activate toll-like receptor signalling, while complement activation and generation of reactive oxygen species induce cytokine and chemokine upregulation. Leukocytes recruited to the infarcted area, remove dead cells and matrix debris by phagocytosis, while preparing the area for scar formation. Timely repression of the inflammatory response is critical for effective healing, and is followed by activation of myofibroblasts that secrete matrix proteins in the infarcted area. Members of the transforming growth factor β family are critically involved in suppression of inflammation and activation of a profibrotic programme. Translation of these concepts to the clinic requires an understanding of the pathophysiological complexity and heterogeneity of postinfarction remodelling in patients with myocardial infarction. Individuals with an overactive and prolonged postinfarction inflammatory response might exhibit left ventricular dilatation and systolic dysfunction and might benefit from targeted anti-IL-1 or anti-chemokine therapies, whereas patients with an exaggerated fibrogenic reaction can develop heart failure with preserved ejection fraction and might require inhibition of the Smad3 (mothers against decapentaplegic homolog 3) cascade. Biomarker-based approaches are needed to identify patients with distinct pathophysiologic responses and to rationally implement inflammation-modulating strategies.
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            Third universal definition of myocardial infarction.

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              Eosinophils from Physiology to Disease: A Comprehensive Review

              Despite being the second least represented granulocyte subpopulation in the circulating blood, eosinophils are receiving a growing interest from the scientific community, due to their complex pathophysiological role in a broad range of local and systemic inflammatory diseases as well as in cancer and thrombosis. Eosinophils are crucial for the control of parasitic infections, but increasing evidence suggests that they are also involved in vital defensive tasks against bacterial and viral pathogens including HIV. On the other side of the coin, eosinophil potential to provide a strong defensive response against invading microbes through the release of a large array of compounds can prove toxic to the host tissues and dysregulate haemostasis. Increasing knowledge of eosinophil biological behaviour is leading to major changes in established paradigms for the classification and diagnosis of several allergic and autoimmune diseases and has paved the way to a “golden age” of eosinophil-targeted agents. In this review, we provide a comprehensive update on the pathophysiological role of eosinophils in host defence, inflammation, and cancer and discuss potential clinical implications in light of recent therapeutic advances.
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                Author and article information

                Journal
                ARYA Atheroscler
                ARYA Atheroscler
                ARYA
                ARYA Atherosclerosis
                Cardiovascular research institute, Isfahan University of Medical Sciences (Isfahan, Iran )
                1735-3955
                2251-6638
                2024
                : 20
                : 6
                : 34-42
                Affiliations
                [1 ]Boali Hospital, Qazvin University of Medical Sciences, Qazvin, Iran
                [2 ]Hearing Disorders Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
                [3 ]Department of Community Medicine, Metabolic Diseases Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
                Author notes
                Address for correspondence: Mahdokht Rezaei; Boali Hospital, Qazvin University of Medical Sciences, Qazvin, Iran; Email: rezaiemahdokht@yahoo.com. Abbas Allami; Boali Hospital, Qazvin University of Medical Sciences, Qazvin, Iran; Email: allami9@yahoo.com
                Article
                10.48305/arya.2024.42494.2942
                11913458
                40103626
                f91a579a-91ff-4f3d-994a-168e383a988e

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, ( https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 5 February 2024
                : 11 November 2024
                Categories
                Original Article

                Orthopedics
                acute myocardial infarction,platelet counts,eosinophil percentage,ejection fraction

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