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The Relationship Between Clinical Outcomes and Calculated Thrombus Burden Before and After Initial Flow in Patients

Oğuzhan Birdal1, Selim Topçu1, İbrahim Halil Tanboğa1

  • 1Department of Cardiology, Atatürk University Faculty of Medicine, Erzurum, Turkey.

The Eurasian Journal of Medicine
|June 15, 2022
PubMed

Insights

Thrombus burden in ST-segment elevation myocardial infarction (STEMI) impacts outcomes. Higher basal thrombus burden predicts no-reflow, while final thrombus burden is linked to 1-year mortality after primary percutaneous coronary intervention.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Acute Coronary Syndromes

Background:

  • Primary percutaneous coronary intervention (PCI) is standard for ST-elevation myocardial infarction (STEMI).
  • High thrombus burden can compromise procedural success and patient outcomes.
  • Assessing thrombus burden may improve risk stratification.

Purpose of the Study:

  • To investigate the association between thrombus burden, assessed before and after initial flow, and clinical outcomes in STEMI patients undergoing primary PCI.
  • To determine if thrombus burden predicts no-reflow and 1-year all-cause mortality.

Main Methods:

  • Retrospective analysis of 1376 STEMI patients treated with primary PCI between May 2012 and November 2015.
  • Thrombus burden quantified using Thrombolysis in Myocardial Infarction (TIMI) thrombus grades (baseline and final).
  • Primary endpoints: post-PCI no-reflow and 1-year all-cause mortality.

Main Results:

  • No-reflow occurred in 12.3% of patients.
  • Higher basal thrombus burden was significantly associated with no-reflow (P < .001).
  • Higher final thrombus burden was significantly associated with 1-year all-cause mortality (P = .047).

Conclusions:

  • Basal thrombus burden is a predictor of no-reflow post-primary PCI.
  • Final thrombus burden is associated with 1-year all-cause mortality in STEMI patients.
  • Quantifying thrombus burden before and after initial flow aids in predicting clinical outcomes.
Abstract

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