High neutrophil density in aspirated thrombus was independently associated with impaired coronary microcirculation (OR 9.430) and left ventricular dysfunction at 6 months in patients with STEMI.
Cohort (n=107)
Does high neutrophil density in aspirated thrombus predict impaired coronary microcirculation and myocardial damage in patients with STEMI undergoing emergency PCI?
High neutrophil density in aspirated thrombus during STEMI is associated with impaired coronary microcirculation, greater myocardial damage, and worse left ventricular function at 6 months.
Effect estimate: OR 9.430 (95% CI 3.777-25.912)
Absolute Event Rate: 79% vs 31%
p-value: p=<0.0001
BACKGROUND: This study was designed to clarify the relationship between myocardial damage and platelet-neutrophil aggregation in patients with acute myocardial infarction (AMI). METHODS AND RESULTS: The study group comprised 107 patients with ST-segment elevation AMI, in whom aspiration catheter was used during emergency percutaneous coronary intervention. Patients were divided into 2 groups according to the cellular density of neutrophils in the aspirated sample: group L (n=53), 100 neutrophils/0.025 mm(2) thrombus. Myocardial blush grade (MBG) <or=1 and ST-segment resolution (STR) <50% were more frequently found in group H than in group L. Peak creatine kinase level tended to be higher and left ventricular ejection fraction (LVEF) at 6 months after onset was lower in group H than in group L. Multivariate analysis showed that high neutrophil density in aspirated thrombus was an independent predictor of MBG <or=1, STR <50%, and low LVEF at 6 months after onset. CONCLUSIONS: Platelet-neutrophil aggregates retrieved from ruptured plaque may be associated with impaired coronary microcirculation and resultant myocardial necrosis/dysfunction. These findings underscore the clinical importance of the interaction between thrombosis and inflammation in the pathogenesis of AMI.
Arakawa et al. (Thu,) conducted a cohort in ST-segment elevation acute myocardial infarction (STEMI) (n=107). High neutrophil density in aspirated thrombus (>100 neutrophils/0.025 mm2) vs. Low neutrophil density (≤100 neutrophils/0.025 mm2) was evaluated on Myocardial blush grade (MBG) 0 or 1 (OR 9.430, 95% CI 3.777-25.912, p=<0.0001). High neutrophil density in aspirated thrombus was independently associated with impaired coronary microcirculation (OR 9.430) and left ventricular dysfunction at 6 months in patients with STEMI.