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Platelet Reactivity Was Not Associated with Infarct Size after Primary Percutaneous Coronary Intervention

Seohwa Park1, Kyeong Ho Yun1, Jae Young Cho1

  • 1Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea.

Chonnam Medical Journal
|October 8, 2021
PubMed

Insights

High platelet reactivity (HPR) did not significantly impact myocardial infarct size in ST-segment elevation myocardial infarction patients after primary percutaneous coronary intervention. Onset to balloon time and anterior infarction were key predictors of larger infarct size.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Nuclear Cardiology

Background:

  • Potent antiplatelet therapy is crucial after primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) to minimize infarct size.
  • Understanding the impact of on-treatment platelet reactivity on infarct size is essential for optimizing treatment strategies.

Purpose of the Study:

  • To investigate the association between on-treatment platelet reactivity and myocardial infarct size in STEMI patients undergoing primary PCI.
  • To identify predictors of infarct size in this patient population.

Main Methods:

  • A retrospective study of 253 STEMI patients undergoing primary PCI.
  • Patients were categorized into high platelet reactivity (HPR) and non-HPR groups based on platelet reactivity measurements.
  • Infarct size was quantified using Technetium Tc-99m tetrofosmin single-photon emission computed tomography (SPECT) before hospital discharge.

Main Results:

  • No significant difference in infarct size was observed between the HPR and non-HPR groups (22.6±17.3% vs. 24.8±17.7%, p=0.416).
  • Multivariate analysis identified onset to balloon time >240 min (OR=1.92) and anterior infarction (OR=5.28) as independent predictors of large infarct size.
  • High platelet reactivity was not found to be a predictor of infarct size by SPECT imaging.

Conclusions:

  • On-treatment platelet reactivity, assessed by HPR, did not show a significant association with myocardial infarct size in the early phase of STEMI post-primary PCI.
  • Timely reperfusion (shorter onset to balloon time) and infarct location (anterior infarction) are critical determinants of infarct size.

Keywords:
AngioplastyBlood PlateletsMyocardial InfarctionP2Y12 receptors

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