Back to Search Start Over

Intrinsic platelet reactivity and thrombus burden in patients with ST-elevation myocardial infarction

Authors :
Grigorios Tsigkas
George Hahalis
George Makris
Konstantinos Theodoropoulos
Vassilios Gizas
Anastasia Damelou
Periklis Davlouros
Ioanna Xanthopoulou
Dimitrios Alexopoulos
George Kassimis
Source :
Thrombosis research. 131(4)
Publication Year :
2012

Abstract

Introduction In patients with ST elevation myocardial infarction (STEMI) increased platelet reactivity has been described to affect the primary percutanuous coronary intervention (PPCI) outcome. We aimed to evaluate the predictive accuracy of intrinsic platelet reactivity for intracoronary thrombus burden in P2Y12 inhibitor- naive STEMI patients. Patients and Methods In a prospective, observational, cohort study we enrolled 94 consecutive STEMI patients undergoing PPCI, subjected to platelet reactivity assessment prior to any P2Y12 blockade, with visible angiographic thrombus in the infarct related artery (stratified as Grade A, B and C). Platelet-function testing was performed with the VerifyNow point-of-care P2Y12 assay immediately prior to intervention. Results Intrinsic platelet reactivity was higher with greater thrombus burden: Grade A 158.8 ± 51.1 PRU, Grade B 217.4 ± 62.1 PRU and Grade C 243.4 ± 58.6 PRU, p = 0.009 and Spearman r = 0.32 (0.12-0.49 95% CI), p = 0.002. ROC analysis revealed an AUC = 0.7 (Standard error 0.07, p = 0.03). An intrinsic platelet reactivity value of > 220 PRU had 65% sensitivity (53–76 95%CI), 76% specificity (55–91 95%CI), 88% positive predictive value (76–96 95%CI) and 44% negative predictive value (29–60 95%CI) for detection of high thrombus burden. In multivariate analysis intrinsic platelet reactivity > 220 PRU emerged as an independent predictor of high thrombus burden (RR = 1.5, 1.15-2.07 95% CI, p = 0.004). Conclusions In patients admitted with STEMI the intrinsic platelet reactivity -as assessed by a point-of-care assay- is positively associated with the degree of intracoronary thrombus, while having a moderate accuracy in predicting high thrombus burden.

Details

ISSN :
18792472
Volume :
131
Issue :
4
Database :
OpenAIRE
Journal :
Thrombosis research
Accession number :
edsair.doi.dedup.....20869c7aa786a5f187bf748254a0da2a