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Updated: Jan 31, 2026

Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
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Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction

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Can Thrombus Burden Predict Contrast-Induced Nephropathy in Patients With ST-Segment Elevation Myocardial Infarction?

Serhat Sigirci1, Kudret Keskin1, Süleyman Sezai Yildiz1

  • 11 Department of Cardiology, Sisli Hamidiye Etfal Education and Research Hospital, Istanbul, Turkey.

Angiology
|January 10, 2019
PubMed

Insights

Large thrombus burden increases the risk of contrast-induced nephropathy (CIN) in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention. Angiographic thrombus burden is a key predictor of CIN.

Area of Science:

  • Cardiology
  • Nephrology
  • Interventional Cardiology

Background:

  • Contrast-induced nephropathy (CIN) incidence rises with cardiovascular disease severity.
  • Platelet activation and thrombus burden are implicated in CIN pathophysiology.
  • ST-segment elevation myocardial infarction (STEMI) patients are at high risk for CIN.

Purpose of the Study:

  • To investigate the impact of thrombus burden on CIN development in STEMI patients.
  • To identify predictors of CIN in STEMI patients undergoing primary percutaneous coronary intervention.

Main Methods:

  • 883 STEMI patients undergoing primary percutaneous coronary intervention were enrolled.
  • Patients were categorized by thrombus burden (Thrombolysis In Myocardial Infarction Thrombus Grades) and CIN development.
  • Multivariate logistic regression analysis was used to identify independent predictors of CIN.

Main Results:

  • 14.2% of STEMI patients developed CIN; 35.4% had large thrombus burden (TG 4).
  • CIN (+) patients were older, had lower hemoglobin and ejection fraction, and received more contrast media.
  • Large thrombus burden, age, hypertension, and admission glomerular filtration rate were independent predictors of CIN.

Conclusions:

  • Thrombus burden, assessed via angiography, is a significant predictor of CIN in STEMI patients.
  • Measuring thrombus burden can aid in stratifying CIN risk.
  • Early identification of high-risk patients allows for targeted preventive strategies.

Keywords:
acute coronary syndromecontrast-induced nephropathykidney injuryplatelet reactivitythrombus score

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