Why the study?
It was unknown whether intracoronary thrombus components correlate with no-reflow or slow blood flow after stent implantation in direct PCI for acute myocardial infarction.
Does intracoronary thrombus component and AMI onset time correlate with no-reflow or slow blood flow after direct PCI in patients with AMI?
Does intracoronary thrombus component and AMI onset time correlate with no-reflow or slow blood flow after direct PCI in patients with AMI?
Intracoronary white thrombus and longer AMI onset time (>3 hours) are associated with a higher risk of no-reflow or slow blood flow after direct PCI.
White thrombus and delayed onset may raise no-reflow risk after AMI PCI; leaves open whether composition should guide adjunctive strategies.
BACKGROUND: Acute myocardial infarction (AMI) is a leading cause of mortality. Early reperfusion to restore blood flow is crucial to successful treatment. In the current reperfusion regimen, an increasing number of patients have benefited from direct percutaneous coronary intervention (PCI). In order to understand whether there is a correlation between the components of coronary thrombosis and the absence of reflow or slow blood flow after coronary stent implantation in direct PCI, we collected data on direct PCI cases in our hospital between January 2016 and November 2018. AIM: To investigate the correlation between intracoronary thrombus components and coronary blood flow after stent implantation in direct PCI in AMI. METHODS: We enrolled 154 patients (85 male and 69 female, aged 36-81 years) with direct PCI who underwent thrombus catheter aspiration within < 3, 3-6 or 6-12 h of onset of AMI between January 2016 and November 2018. The thrombus was removed for pathological examination under a microscope. The patients of the three groups according to the onset time of AMI were further divided into those with a white or red thrombus. The thrombolysis in myocardial infarction (TIMI) blood flow after stent implantation was recorded based on digital subtraction angiography during PCI. The number of patients with no-reflow and slow blood flow in each group was counted. Statistical analysis was performed based on data such as onset time, TIMI blood flow. CONCLUSION: In direct PCI, the onset time of AMI and color of coronary thrombus are often used to predict whether there will be no reflow or slow blood flow after stent implantation.
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Zhang et al. (2019) studied this question.
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