Key result
AMI is linked to higher blood thrombogenicity compared to stable CAD.
Why the study?
Blood thrombogenicity is considered a determinant factor for acute myocardial infarction but has not been investigated in depth.
Is blood thrombogenicity temporarily elevated in patients with acute myocardial infarction compared to those with stable coronary artery disease?
Observational (n=134)
Is blood thrombogenicity temporarily elevated in patients with acute myocardial infarction compared to those with stable coronary artery disease?
Absolute Event Rate: 1771% vs 1677%
p-value: p=0.010
Blood thrombogenicity is temporarily elevated during the acute phase of myocardial infarction, particularly in patients with initial TIMI flow grade 0/1, and decreases in the chronic phase.
Supports transient thrombogenicity elevation in acute MI; hypothesis-generating for phase-specific antithrombotic strategies pending prospective validation.
Objective Although blood thrombogenicity seems to be one of the determinant factors for the development of acute myocardial infarction (MI), it has not been dealt with in-depth. This study aimed to investigate blood thrombogenicity and its change in acute MI patients. Methods and Results We designed a prospective, observational study that included 51 acute MI patients and 83 stable coronary artery disease (CAD) patients who underwent cardiac catheterization, comparing thrombogenicity of the whole blood between: (1) acute MI patients and stable CAD patients; and (2) acute and chronic phase in MI patients. Blood thrombogenicity was evaluated by the Total Thrombus-Formation Analysis System (T-TAS) using the area under the flow pressure curve (AUC30) for the AR-chip. Acute MI patients had significantly higher AUC30 than stable CAD patients (median [interquartile range], 1,771 [1,585–1,884] vs. 1,677 [1,527–1,756], p = 0.010). Multivariate regression analysis identified acute MI with initial TIMI flow grade 0/1 as an independent determinant of high AUC30 (β = 0.211, p = 0.013). In acute MI patients, AUC30 decreased significantly from acute to chronic phase (1,859 [1,550–2,008] to 1,521 [1,328–1,745], p = 0.001). Conclusion Blood thrombogenicity was significantly higher in acute MI patients than in stable CAD patients. Acute MI with initial TIMI flow grade 0/1 was significantly associated with high blood thrombogenicity by multivariate analysis. In acute MI patients, blood thrombogenicity was temporarily higher in acute phase than in chronic phase.
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Kosugi et al. (2021) conducted an observational in Acute myocardial infarction and stable coronary artery disease (n=134). Acute myocardial infarction vs. Stable coronary artery disease was evaluated on Blood thrombogenicity evaluated by the Total Thrombus-Formation Analysis System (T-TAS) using the area under the flow pressure curve (AUC30) (p=0.010). Acute myocardial infarction was associated with significantly higher blood thrombogenicity compared to stable coronary artery disease (median AUC30 1,771 vs. 1,677, p=0.010).
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