Platelet Reactivity Was Not Associated with Infarct Size after Primary Percutaneous Coronary Intervention

Abstract

Potent antiplatelet therapy after primary percutaneous coronary intervention (PCI) has the potential to reduce infarct size. This study analyzed the association between on-treatment platelet reactivity and myocardial infarct size in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary PCI. In this single-center, retrospective study, 253 patients who underwent primary PCI for STEMI were divided into two groups according to platelet reactivity measurements (53 patients in the high platelet reactivity [HPR] group and 200 in the non-HPR group). Technetium Tc-99m tetrofosmin single-photon emission computed tomography (SPECT) was performed before hospital discharge. We measured the infarct size using SPECT imaging and serial cardiac biomarker levels, and compared the infarct sizes of each group. The patients with HPR were older (65.5±13.2 vs. 60.6±12.1 years, p=0.011) than the patients with non-HPR. On the other hand, the non-HPR group had a higher incidence of smoking (26.4% vs. 51.0%, p=0.001) than the HPR group. Infarct size was similar between the two groups (22.6±17.3% vs. 24.8±17.7%, p=0.416). Multivariate analysis revealed that onset to balloon time >240 min (odds ratio [OR]=1.92; 95% confidence interval [CI]=1.08–3.40; p=0.025) and anterior infarction (OR=5.28; 95% CI=3.05–9.14; p<0.001) were independent predictors of large (>22%) infarct size. HPR was not a predictor of infarct size assessed by SPECT. The two groups also showed analogous cumulative creatinine kinase-myocardial band and troponin T levels. In conclusion, compared to non-HPR, HPR showed no significant association with myocardial infarct size measured by SPECT imaging in early phase of MI.

Factors influencing the self-management of kidney transplant patients based on self-determination theory: a cross-sectional study

“…Health care professionals’ autonomy support was not a significant influencing factor, but it did show a significant correlation with competence, autonomous motivation, and self-management. These findings are consistent with previous studies showing that health experts’ support for autonomy did not directly affect the health behavior of patients, but their support did help to sustain patients’ health behavior by enhancing autonomy and competence [ 24 - 27 ]. According to SDT, health care professionals’ autonomy support affects one or more variables among autonomy, competence, and relatedness; internal motivation can develop and changes in health behavior can occur when at least one of these is satisfied [ 7 ].…”

“…Jeong and So [ 25 ] found that the direct effect of healthcare professionals’ autonomy support on patients’ self-care behavior was not significant though the indirect and total effects were significant, consistent with the results of this study. Park [ 26 ] reported that the indirect effect of autonomy support on self-care was significant among patients with percutaneous coronary interventions, consistent with this study. Our results are also similar to those of Austin et al [ 27 ], who found that autonomy support affected self-management behavior via the mediating variable of competence.…”