Prognosis value of platelet-leukocyte aggregation in ST-elevation myocardial infarction patients after primary percutaneous coronary intervention

Abstract

Objective To evaluate the prognostic value of platelet-leukocyte aggregation(PLA)in ST-elevation myocardial infarction(STEMI)patients after primary percutaneous coronary intervention(PCI). Methods A total of 156 STEMI patients after primary PCI were enrolled into this study.Arterial blood of aortic sinus were collected and PLA was measured with flow cytometry.Patients were divided into high PLA group and low PLA group.Myocardial perfusion after primary PCI was evaluated by the sum-ST-segment resolution and TIMI myocardial perfusion grade of coronary angiography.The major adverse cardiac and cerebrovascular events(MACCE)were followed up. Results (1)Compared to low level PLA group, patients in high level PLA group had longer onset-to-balloon time, higher neutrophil ratio, higher Hs-CRP, higher malondialdehyde(all P<0.05), and lower ejection fractions(P<0.05), lower sum-ST-segment resolution(P<0.05). The median time of follow up was of 17.5 months.Incidence of MACCE was 36 patients(23.07%). MACCE incidence in high level PLA group was significantly higher than low level PLA group(34.7% vs. 17.8%, P<0.05). (2)Kaplan-Meier survival analysis indicated that risk of MACCE was higher in high PLA group than low PLA group(Log-rank test P<0.01). (3)Cox regression model analysis showed tha tneutrophil ratio(RR: 1.132, 95% CI: 1.002-1.280)and PLA(RR: 1.101, 95%CI: 1.013-1.196)were associated with MACCE events. Conclusions PLAs could be applied to evaluate myocardial reperfusion, and were directly related to MACCE in patients with STEMI after primary PCI. Key words: Coronary heart disease; Angioplasty, transluminal, percutaneous coronary; Platelet-leukocyte aggregation; Prognosis