QUANTIFICATION OF THROMBUS BURDEN AND IDENTIFICATION OF ITS DETERMINANTS IN PATIENTS OF ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION UNDERGOING PRIMARY PERCUTANEOUS INTERVENTION
DOI:
https://doi.org/10.54112/bcsrj.v2024i1.1011Keywords:
Keywords: Percutaneous Coronary Intervention, Thrombus Burden, STEMI, TIMI FlowAbstract
Primary PCI is the gold standard treatment of STEMI. Thrombus Burden in coronary vessels is the main challenge for a good procedure prognosis. We aimed to analyze thrombus burden and to identify its determinants. Objective: To evaluate the extent of thrombus burden in coronary vessels and identify associated determinants in patients treated with primary PCI. Methods: A single center cross-sectional survey that included 470 patients was conducted at the Punjab Institute of Cardiology, Lahore from June 2023 to December 2023. We recorded demographics and risk factors in history. The angiographic findings about thrombus burden and TIMI flow were recorded before and after the procedure. All the collected data was analyzed using SPSS 23.00. Results: The mean age of the participants was 51.97±10.84 years. 410 (87.2%) were male patients and 60(12.8%) females were included in this study. 283 (60.2%) patients in our study had a high thrombus burden, whereas 187 (39.8%) patients had a low thrombus burden. There was a significant difference in TIMI flow before and after the procedure (p-value = 0.004). Four patients had no flow. All of them had high thrombus burden but were not found to be associated significantly (p-value>0.05). Conclusion: Most of the patients with STEMI had a high thrombus burden. Risk factors of IHD were not associated with high thrombus burden. 410 (87.2%) were male patients and 60(12.8%) females were included in this study.
Downloads
References
Hamilton B, Kwakyi E, Koyfman A, Foran M. Diagnosis and management of acute coronary syndrome: Diagnostic et prise en charge du syndrome coronarien aigu. African journal of emergency medicine. 2013 Sep 1;3(3):124-33.
Lashari NA, Lakho NI, Memon SA, Ahmed A, Waseem MF. ACUTE CORONARY SYNDROME;: FREQUENCY, CONTRIBUTING FACTORS AND TYPES IN PATIENT WITH TYPICAL CHEST PAIN. The Professional Medical Journal. 2017 Mar 7;24(03):409-13.
Marangmei L, Singh SK, Devi KB, Raut SS, Chongtham DS, Singh KB. Profile of cardiac arrhythmia in acute myocardial infarction patients within 48 hours of admission: A hospital based study at RIMS Imphal. Journal of medical society. 2014 Sep 1;28(3):175-9.
Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, Caforio AL, Crea F, Goudevenos JA, Halvorsen S, Hindricks G. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). European heart journal. 2018 Jan 7;39(2):119-77.
O'Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, De Lemos JA, Ettinger SM, Fang JC, Fesmire FM, Franklin BA, Granger CB. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Journal of the American college of cardiology. 2013 Jan 29;61(4):e78-140.
Lee CH, Cheng CL, Yang YH, Chao TH, Chen JY, Liu PY, Lin CC, Chan SH, Tsai LM, Chen JH, Lin LJ. Trends in the incidence and management of acute myocardial infarction from 1999 to 2008: get with the guidelines performance measures in Taiwan. Journal of the American Heart Association. 2014 Aug 11;3(4):e001066.
Sianos G, Papafaklis MI, Daemen J, Vaina S, van Mieghem CA, van Domburg RT, Michalis LK, Serruys PW. Angiographic stent thrombosis after routine use of drug-eluting stents in ST-segment elevation myocardial infarction: the importance of thrombus burden. Journal of the American College of Cardiology. 2007 Aug 14;50(7):573-83.
Sianos G, Papafaklis MI, Serruys PW. Angiographic thrombus burden classification in patients with ST-segment elevation myocardial infarction treated with percutaneous coronary intervention. Journal of invasive cardiology. 2010 Oct 1;22(10):6B-14B.
Ashraf T, Khan MN, Afaque SM, Aamir KF, Kumar M, Saghir T, Rasool SI, Rizvi SN, Sial JA, Nadeem A, Khan AA. Clinical and procedural predictors and short-term survival of the patients with no reflow phenomenon after primary percutaneous coronary intervention. International journal of cardiology. 2019 Nov 1;294:27-31.
Kaul S. The “no reflow” phenomenon following acute myocardial infarction: mechanisms and treatment options. Journal of Cardiology. 2014 Aug 1;64(2):77-85.
Topaz O, Topaz A, Owen K. Thrombus grading for coronary interventions: the role of contemporary classifications. Interventional Cardiology. 2011 Dec 1;3(6):705.
Davies MJ, Thomas A. Thrombosis and acute coronary-artery lesions in sudden cardiac ischemic death. New England Journal of Medicine. 1984 May 3;310(18):1137-40.
Singh M, Berger PB, Ting HH, Rihal CS, Wilson SH, Lennon RJ, Reeder GS, Bresnahan JF, Holmes Jr DR. Influence of coronary thrombus on outcome of percutaneous coronary angioplasty in the current era (the Mayo Clinic experience). The American journal of cardiology. 2001 Nov 15;88(10):1091-6.
Tarsia G, De Michele M, Polosa D, Biondi-Zoccai G, Costantino F, Del Prete G, Osanna RA, Innelli P, Sisto F, Sheiban I, Lisanti P. Manual versus nonmanual thrombectomy in primary and rescue percutaneous coronary angioplasty. Heart and vessels. 2010 Jul;25:275-81.
Abdi S, Rafizadeh O, Peighambari M, Basiri H, Bakhshandeh H. Evaluation of the clinical and procedural predictive factors of no-reflow phenomenon following primary percutaneous coronary intervention. Research in cardiovascular medicine. 2015 Apr 1;4(2):1-6.
Tanboga IH, Topcu S, Aksakal E, Kalkan K, Sevimli S, Acikel M. Determinants of angiographic thrombus burden in patients with ST-segment elevation myocardial infarction. Clinical and Applied Thrombosis/Hemostasis. 2014 Oct;20(7):716-22.
Fajar JK, Heriansyah T, Rohman MS. The predictors of no reflow phenomenon after percutaneous coronary intervention in patients with ST elevation myocardial infarction: A meta-analysis. Indian Heart Journal. 2018 Dec 1;70:S406-18.
Kumar R, Khan KA, Shah JA, Ammar A, Kumar D, Khowaja S, Sial JA, Kazmi S, Murtaza M, Karim M. Quantification Of Thrombus Burden As An Independent Predictor Of Intra-Procedural No-Reflow In Patients With St-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Revascularization. Journal of Ayub Medical College Abbottabad-Pakistan. 2022 Apr 1;34(2).
Zhou H, He XY, Zhuang SW, Wang J, Lai Y, Qi WG, Yao YA, Liu XB. Clinical and procedural predictors of no-reflow in patients with acute myocardial infarction after primary percutaneous coronary intervention. World Journal of Emergency Medicine. 2014;5(2):96.
Feinstein AR, Cicchetti DV. High agreement but low kappa: I. The problems of two paradoxes. Journal of clinical epidemiology. 1990 Jan 1;43(6):543-9.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 AR KHAN , M AQEEL , R AHMAD , S HAMID , A ARSHAD , S ZAHOOR
![Creative Commons License](http://i.creativecommons.org/l/by-nc/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.