December 16, 2016
Ver artículo completoRelationship between Serum Inflammatory Biomarkers and Thrombus Characteristics in Patients with ST Segment Elevation Myocardial Infarction
Resultado clave
High CRP levels in STEMI patients were associated with more frequent TIMI flow 0/1 (69.3% vs 48.5%, p=0.04), whereas high MPO levels were associated with more early thrombi (42.5% vs 20.0%, p=0.04).
Diseño del estudio
Tipo
Observational (n=140)
PICO estructurado
Do serum inflammatory biomarkers (CRP and MPO) correlate with thrombus characteristics in patients with STEMI?
P
Población
140 patients with STEMI referred for primary percutaneous intervention who underwent OCT assessment, blood sampling, and histologic analysis of the thrombus.
E
Exposición
Assessment of high C-reactive protein (CRP) and myeloperoxidase (MPO) levels.
C
Comparador
Low levels of CRP and MPO (based on median thresholds).
O
Resultado
Angiographic and optical coherence tomography (OCT) data pertinent to thrombi, and histologic characteristics of aspirated thrombi.surrogate
In STEMI patients, CRP is associated with greater thrombus burden while MPO is associated with early thrombus age, suggesting different pathogenic mechanisms.
Resultado numérico
Tasa de eventos absoluta: 69.3% vs 48.5%
valor p: p=0.04
Resumen
OBJECTIVES: To compare angiographic and optical coherence tomography (OCT) data pertinent to thrombi, along with the histologic characteristics of aspirated thrombi in patients presenting with ST elevation myocardial infarction (STEMI) with or without inflammation, as assessed by C-reactive protein (CRP) and myeloperoxidase (MPO). METHODS: In the OCTAVIA (Optical Coherence Tomography Assessment of Gender Diversity in Primary Angioplasty) study, 140 patients with STEMI referred for primary percutaneous intervention were enrolled. The patients underwent OCT assessment of the culprit vessel, along with blood sampling of CRP and MPO, and histologic analysis of the thrombus. RESULTS: Biomarkers were available for 129 patients, and histology and immunohistochemistry of the thrombi were available for 78 patients. Comparisons were made using the median thresholds of CRP and MPO (2.08 mg/L and 604.124 ng/mL, respectively). There was no correlation between CRP and MPO levels in the whole population (p = 0.685). Patients with high CRP levels had higher thrombus grades and more frequent TIMI flow 0/1 compared with those with low CRP levels (5 1st quartile 3; 3rd quartile 5 vs. 3.5 mg/L 1; 5, p = 0.007, and 69.3 vs. 48.5%, p = 0.04, respectively). Patients with high MPO levels more commonly had early thrombi than had those with low MPO levels (42.5 vs. 20.0%, p = 0.04). CONCLUSIONS: CRP and MPO were not correlated in STEMI patients, possibly reflecting different pathogenic mechanisms, with CRP more related to thrombus burden and MPO to thrombus age.