Relation of Angiographic Thrombus Burden with Severity of Coronary Artery Disease in Patients with ST Segment Elevation Myocardial Infarction
Hakan Duman, Mustafa Çetin, Murtaza Emre Durakoğlugil, Hüsnü Değirmenci, Hikmet Hamur, Mehmet Bostan, Zakir Karadağ, Yüksel Çiçek
Department of Cardiology, Faculty of Medicine, Recep Tayyip Erdoğan University, Rize, Turkey
Med Sci Monit 2015; 21:3540-3546
We planned to investigate the relationship of thrombus burden with SYNTAX score in patients with ST elevation myocardial infarction (STEMI).
MATERIAL AND METHODS: We retrospectively enrolled 780 patients who underwent PPCI in our clinic due to STEMI. Clinical, laboratory, and demographic properties of the patients were recorded. Angiographic coronary thrombus burden was classified using thrombolysis in myocardial infarction (TIMI) thrombus grades.
RESULTS: Patients with high thrombus burden were older, with higher diabetes prevalence longer pain to balloon time, higher leukocyte count, higher admission troponin, and admission CK-MB concentrations. SYNTAX score was higher and myocardial perfusion grades were lower in patients with high thrombus burden. Multivariate logistic regression analysis revealed SYNTAX score as the strongest predictor of thrombus burden. ROC analysis demonstrated a sensitivity of 75.5%, specificity of 61.2%, and cut-off value of >14 (area under the curve (AUC): 0.702; 95% confidence interval [CI]: 0.773–0.874;P<0.001) for high thrombus burden.
CONCLUSIONS: SYNTAX score may have additional value in predicting higher thrombus burden besides being a marker of coronary artery disease severity and complexity.
Keywords: Adult, Biomarkers - blood, Coronary Angiography, Coronary Artery Disease - surgery, Forecasting, Myocardial Infarction - surgery, percutaneous coronary intervention, ROC Curve, Thrombosis - pathology