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

• 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
• Journal Title: JACC-BASIC TO TRANSLATIONAL SCIENCE
• Volume: Volume 6, Number 9-10
• Publisher: ELSEVIER SCIENCE INC | 2021-10-25, Pages 749-761
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1016/j.jacbts.2021.08.007
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Cardiac & Cardiovascular Systems; Cardiovascular System & Cardiology; acute myocardial infarction; cardiovascular event; clot strength; coronary microvascular dysfunction; thrombogenicity; MICROCIRCULATORY RESISTANCE; PROGNOSTIC VALUE; INTERVENTION; OBSTRUCTION; UTILITY; SIZE

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.