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Relationships between indicators of prothrombotic activity and coronary microvascular dysfunction in patients with

Darya A Vorobeva1, Vyacheslav V Ryabov2, Julia G Lugacheva2

  • 1Tomsk National Research Medical Centre, Cardiology Research Institute, Russian Academy of Sciences, 111a, Kievskaya str, Tomsk, 634012, Russian Federation. darya.lipnyagova@yandex.ru.

BMC Cardiovascular Disorders
|December 6, 2022
PubMed

Insights

Prothrombotic activity and coronary microvascular dysfunction (MVD) were compared in myocardial infarction patients. Plasminogen predicted MVD in MINOCA patients, while WMSI predicted MVD in MI-CAD patients.

Area of Science:

  • Cardiology
  • Hematology
  • Vascular Biology

Background:

  • Coronary microvascular dysfunction (MVD) is increasingly recognized, but its link to prothrombotic activity requires further elucidation.
  • Understanding these relationships is crucial for patients with myocardial infarction, particularly those without obstructive coronary artery disease (MINOCA).

Purpose of the Study:

  • To comparatively analyze the association between prothrombotic activity and MVD in patients with MINOCA and myocardial infarction with obstructive coronary artery disease (MI-CAD).

Main Methods:

  • 37 patients (16 MINOCA, 21 MI-CAD) were assessed for prothrombotic markers (protein C, antithrombin, WF, plasminogen, homocysteine).
  • Myocardial perfusion was evaluated using CZT-SPECT, measuring myocardial blood flow (MBF), myocardial flow reserve (MFR), and coronary slow flow (CSF).
  • MVD was defined as MFR ≤ 1.91 ml/min; CSF was defined by corrected TIMI frame count.

Main Results:

  • In MINOCA patients, reduced MFR was significantly associated with plasminogen levels.
  • In MI-CAD patients, reduced MFR was significantly associated with the wall motion score index (WMSI).
  • This suggests distinct prothrombotic and functional contributors to MVD in these patient groups.

Conclusions:

  • Plasminogen is a key factor associated with MVD in MINOCA patients.
  • WMSI is a key factor associated with MVD in MI-CAD patients.
  • Assessing MVD may improve risk stratification and guide targeted antithrombotic therapies for both MINOCA and MI-CAD patients.

Keywords:
Acute myocardial infarctionIndicators of prothrombotic activityMyocardial blood flowMyocardial infarction and non-obstructive coronary artery diseaseMyocardial perfusion imaging

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