Key result
Spontaneous STEMI reperfusion is linked to ~60% higher thrombosis burden, younger age, and lower CTnI.
Why the study?
The clinical and angiographic characteristics of patients with spontaneous reperfusion in STEMI remained to be investigated.
What are the clinical and angiographic characteristics associated with spontaneous reperfusion in patients with STEMI undergoing primary PCI?
Observational (n=519)
No
What are the clinical and angiographic characteristics associated with spontaneous reperfusion in patients with STEMI undergoing primary PCI?
Absolute Event Rate: 56% vs 35%
p-value: p=<0.01
In STEMI patients, spontaneous reperfusion prior to primary PCI is associated with younger age, lower peak troponin levels, higher thrombus burden, and simple culprit lesions often located in the distal LAD.
Spontaneous reperfusion in STEMI associates with younger age, lower cTnI, higher thrombus burden, and distal LAD lesions; leaves open whether these features aid risk stratification.
This study aims to investigate the clinical and angiographic characteristics of patients with spontaneous reperfusion in ST-segment elevation myocardial infarction (STEMI).A total of 519 patients with STEMI were enrolled in this study, who underwent primary percutaneous coronary intervention (PCI) treatments at Beijing Anzhen Hospital from January 2015 to December 2018. The patients were divided into 2 groups according to the TIMI flow grade before primary PCI, the non-spontaneous reperfusion group (TIMI flow grade 0-II) and the spontaneous reperfusion group (TIMI flow grade III). The incidence rate, the clinically relevant factors, and the features of the coronary angiographic lesions of spontaneous reperfusion from the 2 groups were recorded and analyzed.There were significant differences between the 2 groups in age, CTnI peak value, high thrombus burden, and locations of lesions in the distant of left anterior descending artery (LAD) (P = .000, .000, .002, .000, and .003, respectively). However, there were no significant differences between the groups in other clinic aspects including gender, hypertension, diabetes mellitus, smoking history, hyperlipemia, angina pectoris history, culprit vessel distribution, lesion distribution in left circumflex artery (LCX) and right coronary artery (RCA), and collateral circulation (P > .05 for all).Compared to the patients without spontaneous reperfusion, patients with spontaneous reperfusion were younger in age, lower in CTnI peak value, and higher in thrombosis burden, with culprit lesions mostly located in the distant of LAD.
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Wang et al. (2020) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=519). Spontaneous reperfusion vs. Non-spontaneous reperfusion was evaluated on High thrombosis burden (p=<0.01). Spontaneous reperfusion in STEMI patients was associated with younger age, lower peak CTnI values, and a higher thrombosis burden (56% vs 35%, p<0.01) compared to non-spontaneous reperfusion.
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