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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Impact of initial platelet count on baseline angiographic finding and end-points in ST-elevation myocardial
Sahin Kaplan1, Safiye Tuba Kaplan2, Abdulkadir Kiris1
1Department of Cardiology, KTU, Faculty of Medicine Trabzon, Turkey.
Insights
A higher baseline platelet count (BPC) in ST-elevation myocardial infarction (STEMI) patients predicts coronary artery occlusion and poorer outcomes after primary percutaneous coronary intervention (PPCI). Measuring BPC offers prognostic and therapeutic insights.
Area of Science:
- Cardiology
- Interventional Cardiology
- Biomarkers
Background:
- Baseline platelet count (BPC) in ST-elevation myocardial infarction (STEMI) patients may correlate with angiographic findings and long-term outcomes.
- Data on the prognostic value of BPC in STEMI patients undergoing primary percutaneous coronary intervention (PPCI) remain limited.
Purpose of the Study:
- To determine the prognostic value of BPC for baseline angiographic findings.
- To assess the impact of BPC on clinical outcomes in STEMI patients treated with PPCI.
Main Methods:
- 140 consecutive STEMI patients undergoing PPCI had BPC measured on admission.
- Patients were categorized into two groups based on TIMI flow grade (0 vs. 1-3).
- Follow-up was conducted at 1-9 months to evaluate clinical outcomes.
Main Results:
- Higher BPC was significantly associated with TIMI flow-grade 0 (293.7±59.8 vs. 237.7±50.9 x10(9)/L) and longer lesion length.
- Distal embolization, slow-flow, elevated troponin-I, and creatinine kinase levels were more common in the higher BPC group.
- While in-hospital and 30-day MACEs were similar, 6-month MACEs and target vessel revascularization were significantly higher in the higher BPC group.
Conclusions:
- Elevated BPC is a strong predictor of infarct-related artery (IRA) occlusion in STEMI patients treated with PPCI.
- Higher BPC is associated with adverse clinical outcomes at 9 months post-PPCI.
- BPC measurement on admission may offer significant prognostic and therapeutic benefits.
Unlabelled:
The baseline platelet count (BPC) in patients with acute ST elevation myocardial infarction (STEMI) may reflect the baseline anjiografic finding and may also predic long-term outcomes after primary percutaneous coronary intervention (PPCI). Available data for the value of BPC in patients with STEMI treated with PPCI are still questionable. Therefore, we sought to determine the prognostic value of BPC for baseline angiographic finding and the impact of BPC on clinical outcomes of patients treating with PPCI. Blood sample for BPC was obtained on admission in 140 consecutive patients undergoing PPCI. Patients were divided 2 groups that group-1 (104 patients): TIMI flow-grade 0 and group-2 (36 patients): TIMI flow-grade 1-3. Follow-up was performed at 1-9 months. Baseline demographics were comparable, but, BPC was significantly higher in group-1 comparing 2 (293.7±59.8x10(9)/L vs. 237.7±50.9x10(9)/L, p<0.0001), pre-procedural lesion length longer in group-1 comparing 2 (13.6±3.6 mm vs. 11.4±3.9 mm, p:0.003). Distal embolization (19.0% vs. 0.0%, p:0.001), slow-flow (15.2% vs. 2.9%, p:0.033) were more common in group-1 and mean maximum troponin-I level (9.1±4.2 μg/L vs. 5.1±3.9 μg/L, p<0.0001) and mean maximum creatinin kinase (2077.6±1378.4 U/L vs. 1163.4±869.7 U/L, p:<0.0001) were higher in group-1. In-hospital and 30-days major cardiac adverse events (MACEs) (16.5% vs. 5.7%), p:0.14) were similarly in both groups, but, at 6-months target vessel revascularization (13.9% vs. 0.0%, p:0.017) and MACEs significantly higher in the group-1 (24.1% vs. 2.9%, p:0.013).
Conclusion:
A higher BPC without any antithrombotic agent is a strongly predictor of total occlusion of IRA in STEMI treated with PPCI. And a higher BPC associated with poor clinical outcomes at 9-months. Apart from prognostic value, measuring of a BPC on admission may also provide further practical and therapeutic profits.
