Infarct-related Artery Patency In Patients Research Articles

Neutrophil-to-high-density lipoprotein ratio: an independent predictor of infarct-related artery patency in patients with acute myocardial infarction

Aims: The definition of an infarct-related artery (IRA) is a coronary artery occluded by a thrombus or atheroma that causes ischemia during acute myocardial infarction (AMI). Early patency of the IRA is the primary goal of treatment in patients with AMI. The neutrophil/ high-density lipoprotein cholesterol (HDL-C) ratio (NHR) has been recognized as a new inflammatory marker. We aimed to show the possible relationship between NHR and preprocedural IRA patency.
 Methods: Four hundred patients were screened, and 318 were included in the study after exclusion criteria. IRA flow rate before the coronary procedure was determined according to the previously described thrombolysis in myocardial infarction (TIMI). TIMI current 0,1 and 2 patients were considered IRA non-patent, and TIMI-3 patients were considered IRA patent and were divided into two groups. Regression analysis was performed for possible parameters in predicting IRA patency, evaluated in univariable analysis, and those with p-value

Relationship Between High Sensitivity C-reactive Protein to Albumin Ratio With Infarct-related Artery Patency in Patients With Non-ST-segment Elevation Myocardial Infarction.

The C-reactive protein/albumin ratio (CAR) has recently emerged as a marker for poor prognosis or mortality in various patient groups. This study aimed to examine the relationship between serum CAR and infarct-related artery (IRA) patency in 700 consecutive non-ST-segment elevation myocardial infarction (NSTEMI) patients prior to percutaneous coronary intervention. The study population was separated into 2 different groups according to preprocedural IRA patency as assessed by the degree of Thrombolysis in Myocardial Infarction (TIMI) flow. As a result, occluded IRA was defined as TIMI grade 0-1, while patent IRA was defined as TIMI grade 2-3. High CAR (Odds Ratio: 3.153 (1.249-8.022); P < .001) was found to be an independent predictor of occluded IRA. Additionally, CAR was positively correlated with the SYNTAX score, neutrophil/lymphocyte ratio, and platelet/lymphocyte ratio; CAR was negatively correlated with left ventricular ejection fraction. The highest cut-off value of CAR predicting occluded IRA was found to be .18 with 68.3% sensitivity and 67.9% specificity. The area under the curve for CAR was .744 (95% CI: .706-.781) after the receiver-operating characteristic curve assessment.

ST-segment yükselmesiz miyokard enfarktüslü hastalarda serum ürik asit/albümin oranı ile tamamen tıkalı enfarkt ilişkili arter arasındaki ilişki

Aim: Infarct-related artery (IRA) patency before primary percutaneous coronary intervention (pPCI) is linked to improved clinical outcomes and lower mortality in patients with acute coronary syndrome. The purpose of this research was to examine the association between serum uric acid/albumin ratio (UAR) and IRA patency in patients with non-ST-segment elevation myocardial infarction (NSTEMI).Material and Method: We evaluated 430 consecutive patients with NSTEMI in total retrospectively. The study population was divided into 2 groups according to the IRA patency as assessed by the degree of Thrombolysis in Myocardial Infarction (TIMI) flow before pPCI. As a result, completely occluded IRA was defined as TIMI grade 0-1, while patent IRA was defined as TIMI grade 2-3.Results: IRA was found to be occluded in 110 (25.5%) patients prior to the procedure. UAR level (p=&amp;lt;0.001) was found to be higher among the patients with IRA occlusion when compared to the patent group. Regression analysis revealed that UAR (OR:3.125; 95% CI:1.186-8.232, p&amp;lt;0.001), left ventricular ejection fraction (OR:0.917, 95% CI:0.885-0.951, p&amp;lt;0.001) and culprit artery diameter (OR:0.917, 95% CI:0.885-0.951, p&amp;lt;0.001) were independent predictors for an occluded IRA. An UAR cut-off value of &amp;gt;1.40 was detected to prognosticate the occluded IRA with 62.7% sensitivity and 63.8% specificity (AUC: 0.722, 95% CI: 0.671-0.773, p&amp;lt;0.001).Conclusion: UAR is an independent predictor of preprocedural IRA patency in patients with NSTEMI. Thus, UAR may be an easily accessible parameter to diagnose high-risk NSTEMI patients who would benefit from an immediate invasive strategy (&amp;lt;2 hours).

Platelet to Lymphocyte Ratio as a Predictor of Infarct-Related Artery Patency in Patients Undergoing Primary Percutaneous Coronary Intervention

Platelet to Lymphocyte Ratio as a Predictor of Infarct-Related Artery Patency in Patients Undergoing Primary Percutaneous Coronary Intervention

Relationship Between C-Reactive Protein to Albumin Ratio and Infarct-Related Artery Patency in Patients With ST-Segment Elevation Myocardial Infarction.

The C-reactive protein to albumin ratio (CAR) is a predictive marker of systemic inflammatory state in atherosclerotic coronary disease when compared with the predictive value of these 2 markers separately. We investigated the relationship between CAR and infarct-related artery (IRA) patency in patients with ST-segment elevation myocardial infarction (STEMI). The study population (n = 1047) was divided into 2 groups according to IRA patency which was assessed by the Thrombolysis in Myocardial Infarction (TIMI) flow grade. Nonpatent flow was defined as TIMI grade 0 (no-reflow), 1, and 2 flows, and normal flow was defined as TIMI 3 flow. There was a significant positive correlation between CAR and SYNTAX score (r = 0.312, P < .001) and a negative correlation between CAR and TIMI grade flow (r = -0.210, P < .001). At a cutoff level of 0.693, the CAR predicted TIMI no-reflow with a sensitivity of 65.4% and a specificity of 65.5% (area under the curve: 0.670, 95% CI: 0.62-0.71, P < .001). Multivariate logistic regression analyses showed that CAR was an independent predictor of IRA patency (0.003 [0.001-0.029]; P < .001). A higher CAR is a significant and independent predictor of IRA patency in patients with STEMI.

Predictive accuracy of CHA2DS2-VASc score in determining infarct-related artery patency in patients with ST-elevation myocardial infarction

Predictive accuracy of CHA2DS2-VASc score in determining infarct-related artery patency in patients with ST-elevation myocardial infarction

Platelet to Lymphocyte Ratio as a Predictor of Infarct-Related Artery Patency in Patients Undergoing Primary Percutaneous Coronary Intervention

Background: In myocardial infarction (MI) patients, myocardial reperfusion and subsequently, early infarct related artery (IRA) patency are very critical in this emergency situation. Recently, there is growing research on the ability of platelet to lymphocyte ratio (PLR) to be a predictor of outcome and its value as a marker for inflammation and coagulopathy detection. Our work aims at finding the relation between PLR and the prognosis of IRA in STEMI patients. Methodology: Two hundred cases presented with STEMI were included for the study. Patency of IRA was estimated by Thrombolysis in Myocardial Infarction (TIMI) grade. Patent IRA was defined as TIMI grade III flow and occluded IRA was defined as TIMI grade 0-II flow. Blood samples were withdrawn on admission at emergency department to calculate PLR. Results: Forty-one (20.5%) cases revealed TIMI 3 flow in IRA before pPCI. Occluded group showed significantly higher PLR than patent group with mean PLR 231.3±94.2 vs 100.95±37.7 respectively with P value <0.0001. Multivariate regression analysis demonstrated, both HTN [95% CI (- 0.135)-(-0.747)] & PLR ratio [95% CI (-0.001)-(-0.002)] together are the most independent predictors for TIMI flow in IRA (F-ratio=12.2, p<0.001). Conclusion: our results show that high Platelet lymphocyte ratio predicts patency of IRA independently in cases with STEMI before pPCI.

Chronic statin treatment is a predictor of pre-interventional infarct-related artery patency in patients with ST elevation myocardial infarction treated with percutaneous coronary intervention.

Beyond lipid-lowering effects, early statin treatment has beneficial effects on prognosis after acute coronary syndrome. Infarct-related artery (IRA) patency before percutaneous coronary intervention (PCI) is known to be a strong pre-dictor of improved clinical outcome. We aimed to investigate the effects of chronic statin treatment before admission on IRA patency after myocardial infarction. In this study, 938 ST elevation myocardial infarction (STEMI) patients admitted to the hospital within the first 12 h of symptom onset were prospectively enrolled (male, n = 682; female, n = 256; mean age 58.6 ± 12.4 years). All patients underwent emergent primary PCI. Patients were divided into two groups based upon angiographic IRA patency. Impaired IRA patency was defined as Thrombolysis In Myocardial Infarction (TIMI) grade 0 and 1 flow (non-patent IRA group). Angiographic IRA patency was defined as TIMI 2 and 3 flow (patent IRA group). Previous statin usage was more frequent in the patent IRA group (n = 138; 71.9%), than in the non-patent IRA group (n = 110; 14.7%; p < 0.001). Pre-PCI IRA patency was independently associated with body mass index (odds ra-tio [OR] = 1.087, 95% confidence interval [CI] 1.005-1.176, p < 0.001), previous chronic statin use (OR 0.065, 95% CI 0.043-0.098, p = 0.039), ejection fraction (OR 1.041, 95% CI 1.018-1.064, p < 0.001), and SYNTAX score (OR 0.927, 95% CI 0.899-0.957, p < 0.001) in multivariate logistic regression analysis. Chronic pre-treatment with statins is a significant predictor of the IRA patency in patients with STEMI.

Relation Between Neutrophil-to-Lymphocyte Ratio and Index of Microcirculatory Resistance in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

The neutrophil-to-lymphocyte ratio (NLR) has been proved as a reliable inflammatory marker for the atherosclerotic process and as a predictor for clinical outcomes in patients with various cardiovascular diseases. A recent study reported that elevated NLR is associated with impaired myocardial perfusion in patients with ST-segment elevation myocardial infarction (STEMI). We investigated whether NLR is associated with coronary microcirculation as assessed by the index of microcirculatory resistance (IMR) in patients with STEMI who had undergone primary percutaneous coronary intervention (PCI). A total of 123 patients with STEMI who underwent successful primary PCI were enrolled in this study. NLR was obtained on admission, and patients were divided into 3 groups by NLR tertile. IMR was measured using an intracoronary thermodilution-derived method immediately after index PCI. Symptom onset-to-balloon time was significantly longer (p=0.005), and IMR was significantly higher in the high NLR group than that in the low and intermediate groups (21.94 ± 12.87 vs 23.22 ± 12.73 vs 32.95 ± 20.60, p= 0.003). Furthermore, in multiple linear regression analysis, NLR showed an independent positive correlation with IMR (r= 0.205, p= 0.009). In conclusion, NLR has shown positive correlation with IMR, whereas negative association with infarct-related artery patency in patients with STEMI who underwent primary PCI. Therefore, NLR at admission could reflect myocardial damage and the status of coronary microcirculation in patients with STEMI (ClinicalTrials.gov number, NCT02828137).

Increased red cell distribution width predicts occlusion of the infarct-related artery in STEMI

ABSTRACT Objective Infarct-related artery (IRA) patency yields a better outcome in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Red cell distribution width (RDW) emerges as a marker of adverse cardiovascular events and mortality in STEMI. Therefore, we aimed to assess the relationship between IRA patency and RDW value on admission in patients with STEMI undergoing primary PCI. Methods A total of 564 patients with STEMI undergoing primary PCI were recruited in this study. According to thrombolysis in myocardial infarction (TIMI) flow grade in the IRA before PCI, the study population was divided into two groups as TIMI 0 or 1 group (occluded IRA, n = 398) and TIMI 2 or 3 group (patent IRA, n = 166). Results RDW was significantly higher in the occluded IRA group (15.1 ± 1.7 versus 13.4 ± 1.3, p < 0.001) as compared to the patent IRA group. White blood cell (WBC) count, platelet count, creatine kinase-myocardial band (CK-MB) and troponin-I levels were also significantly higher in the occluded IRA group (p < 0.05). Moreover, RDW showed positive correlations with troponin-I (r = 0.397, p < 0.001), CK-MB (r = 0.344, p < 0.001) and WBC (r = 0.219, p < 0.001). In multivariate regression analysis, RDW (OR: 0.483, 95% CI: 0.412–0.567, p < 0.001) and WBC count were significantly and independently associated with IRA patency. Conclusions Our findings suggested that RDW value and WBC count on admission were independent predictors of IRA patency in patients with STEMI. As RDW is an easily available, simple and cheap biomarker, it can be used in daily practice as a novel predictor for IRA patency.

The usefulness of fQRS and QRS distortion for predicting reperfusion success and infarct-related artery patency in patients who underwent thrombolytic therapy.

The aim of this study is to determine whether the presence of fragmented QRS (fQRS) and QRS distortion on admission ECG can be used to predict the success of treatment before beginning thrombolytic therapy (TT). Two hundred and three eligible patients with acute ST elevation myocardial infarction who received TT consecutively between 1 January 2009 and 1 July 2013 were enrolled. The presence of fQRS and QRS distortion was analyzed at admission ECG. The electrocardiographic criteria of reperfusion were defined as 50% or more of ST resolution (STR), whereas the angiographic criteria of reperfusion were defined as thrombolysis in myocardial infarction 2/3 flow in the infarct-related artery. fQRS was detected in 63 (31%) patients. Compared with patients with non-fQRS, STR was lower (46.1±17.7 vs. 73.6±20.9, respectively; P<0.001), thrombolysis failure was higher (44.4 vs. 9.3%, respectively; P<0.001), and thrombolysis in myocardial infarction 0/1 flow was more common (39.7 vs. 10.7%, respectively; P<0.001) in patients with fQRS. Higher numbers of fQRS derivations were significantly related to low percentages of STR (r=-0.615, P<0.001). In predicting occluded infarct-related artery, we found no difference between the negative predictive values of fQRS and inadequate STR after TT (89.3 vs. 95.1%; P>0.05). However, there was no relationship between QRS distortion and failed thrombolysis. fQRS was detected in just 31% of the patients, but we found that it can be used to predict thrombolytic failure. Patients who have this simple marker on admission ECG may be directed to percutaneous interventions as a first-line therapy without any delay.

OP-041 Platelet to Lymphocyte Ratio can be a Predictor of Infarct-related Artery Patency in Patients with ST-segment Elevation Myocardial Infarction

OP-041 Platelet to Lymphocyte Ratio can be a Predictor of Infarct-related Artery Patency in Patients with ST-segment Elevation Myocardial Infarction

Platelet to Lymphocyte Ratio Can be a Predictor of Infarct-Related Artery Patency in Patients With ST-Segment Elevation Myocardial Infarction.

Patency of infarct-related artery (IRA) in patients with ST-segment elevation myocardial infarction (STEMI) before primary percutaneous coronary intervention (pPCI) is associated with lower mortality and better clinical outcome. However, there were little data regarding the predictors of IRA patency before pPCI in the setting of STEMI. We aimed to assess the association of platelet to lymphocyte ratio (PLR) with IRA patency in STEMI. A total of 452 patients were enrolled and categorized as occluded or patent IRA. Patency IRA was assessed by the thrombolysis in myocardial infarction (TIMI) flow grade. Blood samples were obtained on admission to calculate PLR. Of all patients, 92 (20.4%) patients revealed pre-pPCI TIMI 3 flow in IRA. The PLR was significantly higher in occluded IRA group (138.4 ± 51.4 vs 95.4 ± 43.5, P < .001). Glucose, troponin I, and neutrophil to lymphocyte ratio (NLR) levels were also higher in occluded IRA group (P < .05). Multivariate regression analysis demonstrated the PLR (odds ratio [OR]: 0.987; 95% confidence interval [CI]: 0.978-0.995, P = .002) and NLR (OR: 0.758; 95% CI: 0.584-0.985, P = .038) on admission as independent predictors of IRA patency. In conclusion, a higher PLR is a powerful and independent predictor of IRA patency in patients with STEMI before pPCI.

Neutrophil to Lymphocyte Ratio in Acute ST-Segment Elevation Myocardial Infarction

BackgroundSpontaneous early patency of infarct-related artery (IRA) on arrival for primary percutaneous coronary intervention is associated with better short- and long-term prognosis in patients with ST-segment elevation myocardial infarction (STEMI). We aimed to investigate whether the hemographic parameters on admission are associated with spontaneous IRA patency. MethodsThis was a retrospective study of 1,625 patients with acute STEMI who underwent primary percutaneous coronary intervention <12hours after the onset of symptoms. ResultsAngiography showed patent IRA (prethrombolysis in myocardial infarction [TIMI] grade 3 flow) in 160 (9.8%) patients. Neutrophil count on admission (7.8 ± 2.4 × 103/μL versus 9.7 ± 3.8 × 103/μL; P < 0.001) was significantly lower and lymphocyte count (2.4 ± 1.0 × 103/μL versus 1.9 ± 1.1 × 103/μL; P < 0.001) on admission was significantly higher in the patent IRA group. Neutrophil to lymphocyte ratio (NLR) was significantly lower in the patent IRA group (4.1 ± 3.2 versus 6.9 ± 5.5; P < 0.001). Admission leukocyte counts (13 ± 4.0 × 103/μL versus 12 ± 3.4 × 103/μL; P < 0.001) and NLR (7.2 ± 5.8 versus 5.5 ± 4.4; P < 0.001) of the patients with TIMI thrombus score ≥4 were significantly higher than patients with TIMI thrombus score <4. In the multivariate analysis, NLR ≥4.5 (3.17 [95% confidence interval: 2.04-4.92]; P < 0.001) was found to be independently predicting an occluded IRA on initial angiography with a sensitivity of 62.7% and a specificity of 70%. ConclusionsNLR on admission is significantly related to angiographic thrombus burden and spontaneous early IRA patency in patients with acute STEMI.

Impact of infarct-related artery patency before primary PCI on outcome in patients with ST-segment elevation myocardial infarction: the HORIZONS-AMI trial

We assessed the impact of early infarct-related artery (IRA) recanalisation on the outcomes of patients in the recently conducted, large-scale, multicentre HORIZONS-AMI trial. Of the 3,602 patients enrolled in the HORIZONS-AMI trial, 3,093 patients (85.9%) were treated with percutaneous coronary intervention (PCI) to a single artery. We analysed one-year outcomes in these patients according to the presence or absence of early IRA patency, defined as Thrombolysis in Myocardial Infarction (TIMI) 2 or 3 flow in the IRA. Baseline coronary angiography showed early IRA patency in 1,121 patients (36.2%), while 1,972 patients (63.8%) had TIMI 0 or 1 flow. The presence compared with the absence of early IRA patency was associated with better angiographic results after primary PCI with more TIMI 3 flow after PCI (93.2% vs. 82.9%, p<0.0001) and myocardial blush grade 2 or 3 (84.4% vs. 71.1%, p<0.0001). Early IRA patency was associated with lower rates of one-year mortality (2.5% vs. 3.9%, p=0.04) and definite or probable stent thrombosis (2.0% vs. 4.0%, p=0.002). In multivariable analysis, early IRA patency at baseline angiography was an independent predictor of reduced mortality at one year (HR 0.58, 95% CI: 0.36-0.98, p=0.02). Early IRA patency in patients with STEMI undergoing primary PCI is associated with better TIMI flow and myocardial blush post PCI and is an independent predictor of lower one-year mortality. ClinicalTrials.gov identifier NCT00433966.

The relationship between platelet reactivity and infarct-related artery patency in patients presenting with a ST-elevation myocardial infarction

Both heightened platelet reactivity and an occluded infarct related artery (IRA) on initial angiography and at the time of primary percutaneous coronary intervention (PCI) are associated with a worsened clinical outcome in patients with ST-elevation myocardial infarction (STEMI). However, the relationship between platelet reactivity and IRA patency has not yet been established. Consecutive STEMI-patients were enrolled in this study. Patients who had TIMI-flow (thrombolysis in myocardial infarction) 0 or 1 on initial angiography constituted the occluded IRA group and patients having TIMI-flow 2 or 3 comprised the IRA patent group. Platelet function measurements were performed using the PFA-100 COL/ADP cartridge and light transmittance aggregometry without agonist (spontaneous) and after stimulation with adenosine diphosphate (ADP) and arachidonic acid (AA). Ninety-nine patients were enrolled, of whom 49 presented with an occluded IRA. Multivariate analysis identified the following independent factors to be associated with an occluded IRA; short COL/ADP closure time (ORper quartile increase=0.60; 95% CI, 0.39-.93; p=0.02), the 20 μM ADP-induced light transmittance aggregometry (ORper quartile increase =1.77; 95% CI, 1.15-2.73; p=0.01) and leukocyte counts (odds ratio [OR]=1.21; 95% CI, 1.05-1.39; p = 0.008). In conclusion, heightened platelet reactivity and elevated leukocyte counts are associated with an occluded IRA upon presentation in STEMI-patients. These results emphasise the importance of potent antithrombotic therapy early after the onset of symptoms, to obtain early recanalisation of the IRA.

ST‐Segment Resolution Prior to Primary Percutaneous Coronary Intervention Is a Poor Indicator of Coronary Artery Patency in Patients with Acute Myocardial Infarction

The prognostic value of ST-segment resolution (STR) after initiation of reperfusion therapy has been established by various studies conducted in both the thrombolytic and mechanic reperfusion era. However, data regarding the value of STR immediately prior to primary percutaneous coronary intervention (PCI) to predict infarct-related artery (IRA) patency remain limited. We investigated whether STR prior to primary PCI is a reliable, noninvasive indicator of IRA patency in patients with ST-segment elevation myocardial infarction (STEMI). The study population consisted of STEMI patients who underwent primary PCI at our institution between 2000 and 2007. STR was analyzed in 12-lead electrocardiograms recorded at first medical contact and immediately prior to primary PCI and defined as complete (> or =70%), partial (70%- 30%), or absent (<30%). In 1253 patients with a complete data set, STR was inversely related to the probability of impaired preprocedural flow (P(for trend) < 0.001). Although the sensitivity of incomplete (<70%) STR to predict a Thrombolysis in Myocardial Infarction (TIMI) flow of <3 was 96%, the specificity was 23%, and the negative predictive value of incomplete STR to predict normal coronary flow was only 44%. This study establishes the correlation between STR prior to primary PCI and preprocedural TIMI flow in STEMI patients treated with primary PCI. However, the negative predictive value of incomplete STR for detection of TIMI-3 flow is only 44% and therefore should not be a criterion to refrain from immediate coronary angiography in STEMI patients.

Impact of metabolic syndrome on coronary patency after thrombolytic therapy for acute myocardial infarction

The metabolic syndrome (MS) is highly prevalent in patients with acute myocardial infarction. It has been shown that MS is associated with poor in-hospital outcome and long-term survival in patients with acute myocardial infarction. We aimed to investigate the effect of MS on the infarct-related artery patency in patients treated with thrombolytic therapy for acute myocardial infarction. We retrospectively analyzed 116 patients who were admitted to our clinics with acute ST elevation myocardial infarction and received thrombolytic therapy within 12 h of chest pain. MS was diagnosed according to National Cholesterol Education Program Adult Treatment Panel III criteria. The flow in the infarct-related artery was analyzed according to the thrombolysis in myocardial infarction (TIMI) flow grade and corrected TIMI frame count. MS was present in 55.2% of patients. The proportion of patients with MS who achieved TIMI grade 3 f low after thrombolysis was significantly lower than that of patients without MS (41.5 vs. 58.5%, P < 0.001). Moreover, corrected TIMI frame counts were significantly higher inpatients with MS (58.3+/-34.8 vs. 44.7+/-28.1, P =0.02). On multivariate logistic regression analysis MS was the only independent predictor of TIMI flow less than 3 (P =0.03,odds ratio = 3.545, 95% confidence interval: 1.064-11.808). We have shown for the first time that patients with MS have lower rates of TIMI grade 3 flow and higher corrected TIMI frame counts after thrombolytic therapy for acute myocardial infarction.

Relationship of admission haematological indices with infarct-related artery patency in patients with acute ST-segment elevation myocardial infarction treated with primary angioplasty

Mean platelet volume (MPV), a marker for platelet reactivity, and white blood cell count (WBC-C), a marker for inflammation, have been shown to be predictive of unfavourable outcomes among survivors of ST elevation myocardial infarction (STEMI). The relationship of admission MPV and WBC-C with infarct-related artery (IRA) patency is not clear. We aimed to evaluate the value of admission MPV and WBC-C for the prediction of IRA patency, in patients with acute STEMI treated with primary percutaneous coronary intervention. Blood samples were obtained on admission in 351 STEMI patients. The patients who had thrombolysis in myocardial infarction (TIMI) 3 flow in initial angiography constituted the IRA patent group and others having less than TIMI 3 flow constituted the IRA occluded group. In 16% of the patients, IRAs were found to be patent on initial angiography. Patients in the IRA occluded group had higher admission MPVs (9.3+/-1.2 vs. 8.6+/-1.3 fl, P<0.001) and higher WBC-C (13.3+/-4.8 vs. 11.0+/-2.9, P=0.002) compared with patients in the patent IRA group. In regression analysis, WBC-Cs [beta, 0.131; odds ratio (OR), 1.140; 95% confidence interval (CI), 1.043-1.245, P=0.004)] and MPV (beta, 0.519; OR, 1.680; 95% CI, 1.206-2.339, P=0.002) were found to be independent predictors of occluded IRA. The best cutoff value of MPV for predicting an occluded IRA was determined to be 8.55 fl with a sensitivity of 74% and a specificity of 60%. MPV and WBC-C at admission might be valuable in the prediction of IRA patency and in planning the need for adjunctive therapy to improve outcomes in patients with STEMI undergoing percutaneous coronary intervention.

Effects of reperfusion on late potentials of the QRS complex in acute myocardial infarction

Cardiac rhythm disorders are common in patients after myocardial infarction. They play an important role in the course and in prognosis of this illness. Signal-averaged electrocardiogram (SAECG) is a non-invasive diagnostic method for the induction of sustained monomorphic ventricular tachycardia. Early opening of the infarct-related artery decreases occurrence of ventricular disorders in these patients. The aim of this study was to establish the connection between the late potentials of the QRS complex (SAECG) and unsuccessful reperfusion in patients with acute myocardial infarction (AMI). After myocardial infarction, presence of SAECG was examined in patients receiving reperfusion therapy in order to establish the treatment outcome. Late potentials in SAECG were determined by computer measurements in regard to criteria for its positivity. The study group consisted of 33 patients. Out of 23 patients with successful reperfusion, only 6 (26.1%) had late potentials, in contrast to the group without reperfusion, 8 (80%) out of 10 patients had late potentials. Based on our results, we can conclude that there is a significant association between the presence of late ORS-complex potentials (SAECG) and unsuccessful reperfusion. Also, we can conclude that presence of late potentials is an independent predictor of infarct-related artery patency in patients with AMI treated with thrombolytic therapy.