Why the study?
Does the presence of red versus white aspirated thrombus affect in-hospital clinical and angiographic outcomes in patients with STEMI undergoing primary PCI?
Observational (n=137)
Single-blind
No
Does the presence of red versus white aspirated thrombus affect in-hospital clinical and angiographic outcomes in patients with STEMI undergoing primary PCI?
In STEMI patients undergoing primary PCI, the presence of red thrombus is associated with longer ischemic times and a higher incidence of in-hospital major adverse cardiovascular events compared to white thrombus.
Red thrombus on aspiration may flag higher in-hospital MACE risk in STEMI; hypothesis-generating for composition-guided strategies.
Objective To investigate differences in clinical and angiographic outcomes between patients with acute myocardial infarction with red and white thrombi. Methods A total of 137 patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary interventions were included. Thrombus material was classified as white or red based on its pathology. Information on characteristics of thrombi was available for 97 (70.8%) patients. Results The total ischaemic time was significantly longer in the red thrombus group compared with the white thrombus group. The incidence of major adverse cardiovascular events in hospital was higher in the red thrombus group than in the white thrombus group (15.6% vs 0%). Multivariable logistic analysis showed that the total ischaemic time was the only predictor of thrombus composition (odds ratio 1.353; 95% confidence interval 1.003, 1.826). Conclusion Red thrombi were present in nearly two-thirds of cases, and were associated with a longer ischaemic time and higher incidence of major adverse cardiovascular events in hospital.
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Yang et al. (2016) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=137). Red thrombus vs. White thrombus was evaluated on In-hospital major adverse cardiovascular events (MACE) (p=0.041).
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