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Kinetics of coagulation in ST-elevation myocardial infarction following successful primary percutaneous coronary

Paul F A Teunissen1, Ruben Tijssen1, Maurits L van Montfoort2

  • 1Department of Cardiology, VU University Medical Center, Amsterdam, The Netherlands.

Thrombosis Research
|December 15, 2015
PubMed

Insights

Coagulation markers change rapidly after ST-elevated myocardial infarction (STEMI) treated with PCI. However, these early changes do not predict long-term cardiac outcomes like ejection fraction or infarct size.

Area of Science:

  • Cardiology
  • Hematology
  • Biochemistry

Background:

  • ST-elevated myocardial infarction (STEMI) is often caused by atherosclerotic plaque rupture and thrombus formation.
  • Kinetics of coagulation markers post-STEMI in patients receiving current guideline-based treatment are not well understood.
  • This study investigates coagulation marker dynamics in percutaneous coronary intervention (PCI)-treated STEMI patients.

Purpose of the Study:

  • To examine the kinetic profiles of key coagulation markers in STEMI patients undergoing PCI.
  • To assess the relationship between early coagulation marker levels and cardiac outcomes determined by cardiac magnetic resonance (CMR).

Main Methods:

  • Prospective study of 60 PCI-treated STEMI patients.
  • Coagulation markers (ADAMTS13, VWF, fibrinogen, D-dimer, α2AP, PAP, F1+2, PT, aPTT, anti-Xa) measured at baseline (90 days post-PCI) and at 1, 4, and 7 days post-PCI.
  • Cardiac magnetic resonance (CMR) assessed LVEF, infarct size, and microvascular injury (MVI) at 4-6 and 90 days post-PCI.

Main Results:

  • Immediately post-PCI, ADAMTS13, fibrinogen, and α2AP levels decreased, while VWF activity, antigen, and propeptide levels increased compared to baseline.
  • No significant correlations were found between individual or combined coagulation markers and LVEF, infarct size, or MVI at specified time points.

Conclusions:

  • Coagulation parameters exhibit dynamic changes in the early phase following STEMI.
  • These early coagulation marker dynamics do not serve as predictors for CMR-defined left ventricular ejection fraction, infarct size, or microvascular injury.
Abstract

Keywords:
Acute myocardial infarctionCardiac magnetic resonanceCoagulation factorsPercutaneous coronary intervention

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