Association between serum SCUBE1 levels and thrombus burden in patients with ST-segment elevation myocardial infarction

Prognostic significance of refractory thrombus in STEMI patients and the role of red cell distribution width: A case-control study

The high thrombus burden of the infarct-related artery (IRA) is associated with the adverse prognosis in ST-segment elevation myocardial infarction (STEMI) patients. Our objectives were to investigate the predictors and evaluate the prognosis of refractory thrombus in STEMI patients. A total of 1305 consecutive patients with STEMI who underwent primary percutaneous coronary intervention (pPCI) were screened. The refractory thrombus group (n = 15) was defined as IRA thrombolysis in myocardial infarction flow < grade 2 after multiple thrombus aspiration (TA). The control group (n = 45) was age- and sex-matched and was selected from the same batch of patients. Baseline hematologic indices were measured before the pPCI. The major adverse cardiovascular events (MACE) were recorded during follow-up. The refractory thrombus group had significantly higher red cell distribution width (RDW) at baseline compared with the control group (13.1 [12.4-13.7] vs 12.6 [12.3-12.8], P = .008). In multivariate logistic regression analysis, RDW was an independent predictor of refractory thrombus (odds ratio: 8.799, 95% CI: 1.240-62.454, P = .030). The area under the receiver-operating characteristic curve of the RDW was 0.730 (95%CI: 0.548-0.912, P = .008). During a mean period of 26 months follow-up, patients in the refractory thrombus group tended to have higher percent MACEs compared with patients in the control group (53.3% vs 6.7%, P < .001). In the present study, we found that the refractory thrombus in STEMI patients was associated with the worse prognosis and the increased RDW might be a potential independent predictor.

Relationship between intracoronary thrombus burden and systemic immune-inflammation index in patients with ST-segment elevation myocardial infarction

AIM

This study aimed to evaluate the relationship between intracoronary thrombus burden and systemic immune-inflammation index (SII) and to compare the predictive capacity of SII together with the neutrophil-lymphocyte ratio (NLR), and the platelet-lymphocyte ratio (PLR) in patients with ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PPCI).

PATIENT & METHODS

A total of 425 patients were included in the study. The clinical, laboratory, and demographic characteristics of the patients were recorded. The thrombus classification "Thrombolysis in myocardial infarction (TIMI)" was used to assess the intracoronary thrombus burden. According to the TIMI thrombus classification, 229 (54%) patients with low thrombus burden (grade 0-3) and 196 (46%) patients with high thrombus burden (grade 4 and 5) were compared. SII was calculated as platelet × neutrophil/lymphocyte counts.

RESULTS

High NLR (OR: 1.068, 95% CI:1.023-1.404; p = 0.031), PLR(OR: 1.012, 95% CI:1.002-1.018; p = 0.043), SII(OR: 1.325, 95% CI: 1.156-1.879; p = 0.015) and low left ventricle ejection fraction (LVEF) (OR: 0.957, 95% CI:0.924-0.990; p = 0.012) were found to be independent predictors of high thrombus burden. SII values above 812 predicted a high thrombus burden with a sensitivity of 82% and specificity of 73% (AUC: 0.836; 95% CI:0.795-0.877; p < 0.001). This predictiveness of SII was stronger as compared to NLR (0.836 vs. 0.818, p = 0.043) and PLR (0.836 vs. 0.780, p < 0.001).

CONCLUSION

SII is an independent predictor of high thrombus burden in patients with STEMI. In addition, SII is superior to NLR and PLR in this regard.

Relationship between blood viscosity and no-reflow phenomenon in ST-segment elevation myocardial infarction performed in primary percutaneous coronary interventions

Background: This study aimed to analyze the associations between no-reflow (NR) phenomenon development and whole-blood viscosity in patients with ST-elevated myocardial infarction. Methods: A total of 217 patients with ST-elevated myocardial infarction were included. whole-blood viscosity values were assessed using hematocrit and total protein values, and low shear rate (LSR) and high shear rate (HSR) were calculated. Results: The average LSR and HSR values of the study group were significantly higher than the control group (p < 0.001). Multivariate logistic regression analysis showed that both HSR (odds ratio: 4.957; p < 0.001) and LSR (odds ratio: 1.114; p < 0.001) were independent predictors for NR development. Conclusion: This study found that increased blood viscosity was an independent predictor for NR development.