Association Between Thrombogenicity Indices and Coronary Microvascular Dysfunction in Patients With Acute Myocardial Infarction

• Type of Material: Article
• Authors: Min Gyu Kang, Gyeongsang National University Hospital; Bon-Kwon Koo, Seoul Natl Univ Hosp; Udaya S Tantry, Sinai Hospital of Baltimore; Kyehwan Kim, Gyeongsang National University Changwon Hospital; Jong-Hwa Ahn, Gyeongsang National University Changwon Hospital; Hyun Woong Park, Gyeongsang National University Changwon Hospital; Jeong Rang Park, Gyeongsang National University Changwon Hospital; Seok-Jae Hwang, Gyeongsang National University Changwon Hospital; Jin-Yong Hwang, Gyeongsang National University Changwon Hospital; Paul A Gurbel, Sinai Hospital of Baltimore; Habib Samady, Emory University; Jing-Sin Koh, Gyeongsang National University Changwon Hospital; Young-Hoon Jeong, Gyeongsang National University Changwon Hospital
• Language: English
• Date: 2021-10-25
• Publisher: ELSEVIER SCIENCE INC
• Publication Version: Final Published Version
• Copyright Statement: © 2021 The Authors
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jacbts.2021.08.007
• Title of Journal or Parent Work: JACC-BASIC TO TRANSLATIONAL SCIENCE
• Volume: 6
• Issue: 9-10
• Start Page: 749
• End Page: 761
• Grant/Funding Information: This study was supported by the Basic Science Research Program through the National Research Foundation (NRF) of Korea funded by the Ministry of Science, ICT, and Future Planning (NRF-2015R1A5A2008833). The content is solely the responsibility of the authors and does not necessarily represent the official views of any funding agencies.
• Keywords: clot strength; PROGNOSTIC VALUE; SIZE; thrombogenicity; Science & Technology; coronary microvascular dysfunction; OBSTRUCTION; Cardiovascular System & Cardiology; cardiovascular event; INTERVENTION; Cardiac & Cardiovascular Systems; UTILITY; MICROCIRCULATORY RESISTANCE; acute myocardial infarction; Life Sciences & Biomedicine
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

The association between thrombogenicity and coronary microvascular dysfunction (CMD) has been poorly explored in patients with acute myocardial infarction (AMI). In our real-world clinical practice (N = 116), thrombogenicity was evaluated with thromboelastography and conventional hemostatic measures, and CMD was defined as index of microcirculatory resistance of >40 U using the invasive physiologic test. High platelet-fibrin clot strength (P-FCS) (≥68 mm) significantly increased the risk of postprocedural CMD (odds ratio: 4.35; 95% CI: 1.74-10.89). Patients with both CMD and high P-FCS had a higher rate of ischemic events compared to non-CMD subjects with low P-FCS (odds ratio: 5.58; 95% CI: 1.31-23.68). This study showed a close association between heightened thrombogenicity and CMD and their prognostic implications after reperfusion in acute myocardial infarction patients.