Association Between Intraprocedural Thrombotic Events and Adverse Outcomes After Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction (a Harmonizing Outcomes With RevasculariZatiON and Stents in Acute Myocardial Infarction [HORIZONS-AMI] Substudy)

Kirtane, Ajay J.; Sandhu, Prabhdeep; Mehran, Roxana; McEntegart, Margaret; Cristea, Ecaterina; Brener, Sorin J.; Xu, Ke; Fahy, Martin; Généreux, Philippe; Wessler, Jeffrey D.; Stone, Gregg W.

doi:10.1016/j.amjcard.2013.08.034

Cited by 30 publications

(26 citation statements)

References 23 publications

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“…The principal finding of the present analysis is that the occurrence of IPTE in the catheterization laboratory during a PCI procedure is associated with a substantial increase in medical costs for patients with NSTEACS. Previous studies have shown that IPTE are not uncommon (occurring in 3.5–11.4% of NSTEACS patients undergoing PCI), and are strongly associated with ischemic and bleeding complications, as well as mortality . The present analysis indicates that IPTE are also associated with ∼20% increases in both in‐hospital and cumulative 30‐day costs.…”

Section: Discussionsupporting

confidence: 56%

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Cost implications of intraprocedural thrombotic events during PCI

Plent

Fan

Kirtane

et al. 2015

Cathet Cardio Intervent

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Section: Discussionsupporting

confidence: 56%

“…While many studies have investigated the predictors of stent thrombosis, to our knowledge only two studies have evaluated the predictors of IPTE using multivariate modeling . Baseline cardiac biomarker elevation and lack of hyperlipidemia were independently associated with the occurrence of IPTE .…”

Section: Discussionmentioning

confidence: 99%

Cost implications of intraprocedural thrombotic events during PCI

Plent

Fan

Kirtane

et al. 2015

Cathet Cardio Intervent

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“…Despite the efficacy of the technique, preprocedural high-thrombus burden (HTB) is a predictor of procedural complications following primary PCI for STEMI [1]. Despite the efficacy of the technique, preprocedural high-thrombus burden (HTB) is a predictor of procedural complications following primary PCI for STEMI [1].…”

Section: Introductionmentioning

confidence: 99%

Predictors of thrombus burden and no-reflow of infarct-related artery in patients with ST-segment elevation myocardial infarction

Cakici

Çetın²,

Ballı³

et al. 2014

Blood Coagulation &Amp; Fibrinolysis

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Preprocedural high-thrombus burden (HTB) of infarct-related artery (IRA) is a harbinger of procedural complications following primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI). The HTB of IRA can lead to poor outcomes by various mechanisms, including no-reflow phenomenon, increased myocardial necrosis and with subsequent reduced survival benefit at follow-up. In this study, we investigated the relationship between all platelet indices on admission and thrombus burden and the no-reflow phenomenon after primary PCI of IRA in patients with STEMI. We retrospectively enrolled 475 patients with STEMI undergoing primary PCI. Study population was divided into two groups according to the thrombolysis in myocardial infarction thrombus grade of IRA as low-thrombus burden or HTB. There were no statistically significant differences in platelet indices, including platelet count, platelet-large cell ratio (P-LCR), mean platelet volume (MPV) and platelet distribution with (PDW) among the groups. However, in the subgroup analysis, P-LCR, MPV and PDW were significantly higher in the no-reflow patients than reflow patients despite similar platelet count (P for all < 0.001). The cutoff value of P-LCR for predicting no-reflow was 26.5% with a sensitivity of 67.0% and a specificity of 62% (area under the curve, 0.689; 95% confidence interval, 0.614-0.765; P < 0.001). Furthermore, P-LCR, MPV and PDW had similar AUC (0.689, P < 0.001; 0.688, P < 0.001; and 0.677, P < 0.001; respectively) for predicting no-reflow phenomenon after primary PCI. As a result, all of the platelet indices have no effect on thrombus load of IRA, however, these parameters seem to impair epicardial perfusion after primary PCI.

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“…Although the threshold of post-PCI biomarker elevation that is prognostically relevant is controversial (3,4), there is general agreement that any level of periprocedural myonecrosis is undesirable. Previous studies have identified baseline clinical and angiographic lesion characteristics that are associated with intraprocedural thrombotic events and post-PCI myocardial infarction (MI) (5)(6)(7)(8). Beyond these conventional features, certain plaque phenotypes may be particularly susceptible to distal embolization, microvascular obstruction, and myonecrosis after PCI.…”

mentioning

confidence: 98%