Author + information
- Billy J. Mullinax,
- Mira Patel,
- Alex Canova,
- Ashley Waring,
- Christopher Neilsen and
- Valerian Fernandes
To study blood cell count changes after alcohol-induced septal infarct in Hypertrophic Obstructive Cardiomyopathy (HOCM) patients.
Atherosclerotic myocardial infarction (MI) is a proinflammatory and prothrombotic state associated with neutrophilic leukocytosis, anemia, and increased platelet count and platelet size. The degree of leukocytosis correlates with infarction size and, together with increased platelets, amplifies myocardial inflammation. Alcohol Septal Ablation (ASA) produces a targeted infarction in the hypertrophied septum to reduce left ventricular outflow obstruction. The inflammatory and thrombotic effects of this iatrogenic alcohol-induced infarction have not been studied.
We evaluated 215 consecutive patients who underwent ASA with pre- and post-ASA hemoglobin, WBC count, platelet counts, and troponin.
A total of 215 patients (age 61.37 ± 13.18, 91M, 124F) who underwent ASA were included in the study. Alcohol (2.10 ± 0.69cc) was injected into a targeted septal artery, producing a peak troponin of 53.46 ± 48.80 ng/ml. After ASA, WBC increased from 7.07 ± 2.03 to 8.22 ± 2.57 (p<0.001), hemoglobin decreased from 13.30 ± 1.82 to 12.22 ± 1.98 (p<0.001), and platelet counts decreased from 200 ± 56 to 177 ± 48 (p <0.001). Different tertiles of hemoglobin, WBC, and platelet counts showed no correlation to peak troponin values following ASA. The volume of alcohol injected did not affect the pre- and post-ASA hemoglobin, WBC, and platelet counts.
Compared to atherosclerotic MI, alcohol-induced infarction also leads to an increase in WBC count and anemia, but unlike atherosclerotic MI there is a reduction in platelet count. This suggests that ASA produces a similar inflammatory response with a reduced thrombotic state. The size of the ASA infarct did not correlate with blood count indices.