Relationship between blood viscosity and thrombus burden in ST-segment elevation myocardial infarction

Kaplangöray, Mustafa; Toprak, Kenan; Çekici, Yusuf; Yıldırım, Arafat; Abacıoğlu, Özge Özcan

doi:10.3233/ch-231756

Cited by 4 publications

(1 citation statement)

References 27 publications

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“…A meta-analysis found that ticagrelor significantly improved endothelial function in comparison with prasugrel, clopidogrel, and placebo, increasing flow-mediated vasodilation, the reactive hyperemia index, and the number of circulating endothelial progenitor cells, while reducing the index of coronary microvascular resistance ( Guan et al, 2022 ). Moreover, ticagrelor could improve blood rheology ( Rosenson et al, 2019 ), which was repeatedly shown to affect clinical outcomes in STEMI ( Kaplangoray et al, 2023a ; Kaplangoray et al, 2023b ; Kaplangoray et al, 2023c ).…”

Section: Discussionmentioning

confidence: 99%

Addition of eptifibatide and manual thrombus aspiration to ticagrelor does not improve long-term survival after STEMI treated with primary PCI

Călburean,

Grebenișan,

Nistor

et al. 2024

Front. Pharmacol.

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Background: Current guidelines recommend that glycoprotein IIb/IIIa inhibitor (GPI) and manual aspiration thrombectomy should not be routinely used in patients with ST-segment elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (pPCI), although there is a lack of dedicated studies. The aim of this study was to examine the impact of combined usage of a potent P2Y12 inhibitor, GPI, and manual aspiration thrombectomy on long-term survival after STEMI.Methods: All STEMI patients treated by pPCI in a tertiary center who have been included prospectively in the local PCI registry between January 2016 and December 2022 were analyzed in this study. Patients were excluded if they required oral anticoagulation or bridging between clopidogrel or ticagrelor during hospitalization.Results: A total of 1,210 patients were included in the present study, with a median follow-up of 2.78 (1.00–4.88) years. Ticagrelor significantly reduced all-cause and cardiovascular-cause mortality [HR = 0.27 (0.21–0.34), p < 0.0001 and HR = 0.23 (0.17–0.30), p < 0.0001, respectively]. Eptifibatide significantly reduced all-cause and cardiovascular-cause mortality [HR = 0.72 (0.57–0.92), p = 0.002, and HR = 0.68 (0.52–0.89), p = 0.001, respectively]. Manual thrombus aspiration had no significant effect on both all-cause and cardiovascular-cause mortality. In multivariate Cox regression, all-cause mortality was reduced by ticagrelor, while eptifibatide or manual thrombus aspiration had no significant effect. However, cardiovascular-cause mortality was reduced by both ticagrelor and eptifibatide, while manual thrombus aspiration had no significant effect.Conclusion: Ticagrelor consistently reduced cardiovascular and all-cause mortality, while eptifibatide reduced only cardiovascular mortality. Manual thrombus aspiration provided no long-term benefit. Our findings support the current guideline recommendation that GPI and manual aspiration thrombectomy should not be routinely used in treatment of STEMI with pPCI.

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Section: Discussionmentioning

confidence: 99%

Addition of eptifibatide and manual thrombus aspiration to ticagrelor does not improve long-term survival after STEMI treated with primary PCI

Călburean,

Grebenișan,

Nistor

et al. 2024

Front. Pharmacol.

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Prognostic value of pan immune-inflammation value in patients undergoing unprotected left main coronary artery stenting

Karaduman,

Yılmaz,

Keten

et al. 2024

Biomarkers in Medicine

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Non-O Blood Group Is Associated with High Thrombus Burden and Poor Short- and Long-Term Prognosis in ST-Segment Elevation Myocardial Infarction Patients

Toprak,

Kaplangöray,

Omar

et al. 2024

Med Princ Pract

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Introduction: This study investigated how non-O blood groups relate to thrombus burden (TB) and prognosis in ST-segment elevation myocardial infarction (STEMI) patients, aiming to shed light on their association with thrombotic complications in cardiovascular diseases. Methods: Retrospectively, 1,180 STEMI patients undergoing primary percutaneous coronary intervention were included. The study population was divided into groups according to TB status and the groups were compared in terms of basic clinical characteristics, laboratory parameters and ABO blood group types. In addition, short-term (30 days) and long-term (12 months) clinical outcomes were assessed to evaluate the prognostic implications. Results: The analysis revealed a significant association between non-O blood groups and increased TB in STEMI patients (p = 0.001). Non-O blood group was independently associated with high TB (OR: 1.726, 95% confidence interval [CI]: 1.279–2.330, p < 0.001). Additionally, patients with non-O blood groups had higher short and long-term mortality rates (hazard ratio [HR]: 2.480, 95% CI: 1.361–4.520, p = 0.003; HR: 2.347, 95% CI: 1.433–3.844, p = 0.001; respectively). Conclusions: This study emphasizes the significance of the ABO blood group system in STEMI outcomes, associating non-O blood groups with higher TB and poorer clinical outcomes. While proposing personalized treatment strategies based on blood group status to improve reperfusion interventions and outcomes, additional trials are needed to comprehensively evaluate their impact.

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Relationship between blood viscosity and thrombus burden in ST-segment elevation myocardial infarction

Cited by 4 publications

References 27 publications

Addition of eptifibatide and manual thrombus aspiration to ticagrelor does not improve long-term survival after STEMI treated with primary PCI

Addition of eptifibatide and manual thrombus aspiration to ticagrelor does not improve long-term survival after STEMI treated with primary PCI

Prognostic value of pan immune-inflammation value in patients undergoing unprotected left main coronary artery stenting

Non-O Blood Group Is Associated with High Thrombus Burden and Poor Short- and Long-Term Prognosis in ST-Segment Elevation Myocardial Infarction Patients

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