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Microfluidics in Assessing Platelet Function
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Intrinsic platelet reactivity and thrombus burden in patients with ST-elevation myocardial infarction

Dimitrios Alexopoulos1, Ioanna Xanthopoulou, Grigorios Tsigkas

  • 1Department of Cardiology, Patras University Hospital, Rion, Patras, Greece. dalex@med.upatras.gr

Thrombosis Research
|March 14, 2013
PubMed

Insights

In ST-elevation myocardial infarction (STEMI) patients, higher intrinsic platelet reactivity predicts greater intracoronary thrombus burden. This finding aids in assessing thrombus severity before primary percutaneous coronary intervention (PPCI).

Area of Science:

  • Cardiology
  • Hematology
  • Interventional Cardiology

Background:

  • Increased platelet reactivity is linked to poorer outcomes in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI).
  • Assessing intrinsic platelet reactivity may help predict thrombus burden in STEMI patients before intervention.

Purpose of the Study:

  • To evaluate the predictive accuracy of intrinsic platelet reactivity for intracoronary thrombus burden.
  • To assess thrombus burden in P2Y12 inhibitor-naïve STEMI patients undergoing PPCI.

Main Methods:

  • Prospective, observational cohort study of 94 consecutive STEMI patients undergoing PPCI.
  • Platelet reactivity assessed using the VerifyNow P2Y12 assay prior to P2Y12 blockade.
  • Intracoronary thrombus burden stratified by angiographic Grade (A, B, C).

Main Results:

  • Intrinsic platelet reactivity showed a positive correlation with thrombus burden (Grade A: 158.8±51.1 PRU, Grade B: 217.4±62.1 PRU, Grade C: 243.4±58.6 PRU; p=0.009).
  • ROC analysis indicated an AUC of 0.7 (p=0.03) for predicting high thrombus burden.
  • An intrinsic platelet reactivity >220 PRU was an independent predictor of high thrombus burden (RR=1.5, p=0.004).

Conclusions:

  • Intrinsic platelet reactivity, measured by a point-of-care assay, is positively associated with intracoronary thrombus degree in STEMI patients.
  • This assay demonstrates moderate accuracy in predicting high thrombus burden, aiding clinical decision-making in PPCI.
Abstract

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