PMID- 23481479
OWN - NLM
STAT- MEDLINE
DCOM- 20140217
LR  - 20220310
IS  - 1879-2472 (Electronic)
IS  - 0049-3848 (Linking)
VI  - 131
IP  - 4
DP  - 2013 Apr
TI  - Intrinsic platelet reactivity and thrombus burden in patients with ST-elevation 
      myocardial infarction.
PG  - 333-7
LID - S0049-3848(13)00054-6 [pii]
LID - 10.1016/j.thromres.2013.02.010 [doi]
AB  - INTRODUCTION: In patients with ST elevation myocardial infarction (STEMI) 
      increased platelet reactivity has been described to affect the primary 
      percutanuous coronary intervention (PPCI) outcome. We aimed to evaluate the 
      predictive accuracy of intrinsic platelet reactivity for intracoronary thrombus 
      burden in P2Y12 inhibitor- naive STEMI patients. PATIENTS AND METHODS: In a 
      prospective, observational, cohort study we enrolled 94 consecutive STEMI 
      patients undergoing PPCI, subjected to platelet reactivity assessment prior to 
      any P2Y12 blockade, with visible angiographic thrombus in the infarct related 
      artery (stratified as Grade A, B and C). Platelet-function testing was performed 
      with the VerifyNow point-of-care P2Y12 assay immediately prior to intervention. 
      RESULTS: Intrinsic platelet reactivity was higher with greater thrombus burden: 
      Grade A 158.8+/-51.1 PRU, Grade B 217.4+/-62.1 PRU and Grade C 243.4+/-58.6 PRU, 
      p=0.009 and Spearman r=0.32 (0.12-0.49 95% CI), p=0.002. ROC analysis revealed an 
      AUC=0.7 (Standard error 0.07, p=0.03). An intrinsic platelet reactivity value of 
      >220 PRU had 65% sensitivity (53-76 95%CI), 76% specificity (55-91 95%CI), 88% 
      positive predictive value (76-96 95%CI) and 44% negative predictive value (29-60 
      95%CI) for detection of high thrombus burden. In multivariate analysis intrinsic 
      platelet reactivity >220 PRU emerged as an independent predictor of high thrombus 
      burden (RR=1.5, 1.15-2.07 95% CI, p=0.004). CONCLUSIONS: In patients admitted 
      with STEMI the intrinsic platelet reactivity -as assessed by a point-of-care 
      assay- is positively associated with the degree of intracoronary thrombus, while 
      having a moderate accuracy in predicting high thrombus burden.
CI  - Copyright (c) 2013 Elsevier Ltd. All rights reserved.
FAU - Alexopoulos, Dimitrios
AU  - Alexopoulos D
AD  - Department of Cardiology, Patras University Hospital, Rion, Patras, Greece. 
      dalex@med.upatras.gr
FAU - Xanthopoulou, Ioanna
AU  - Xanthopoulou I
FAU - Tsigkas, Grigorios
AU  - Tsigkas G
FAU - Damelou, Anastasia
AU  - Damelou A
FAU - Theodoropoulos, Konstantinos C
AU  - Theodoropoulos KC
FAU - Makris, George
AU  - Makris G
FAU - Gizas, Vassilios
AU  - Gizas V
FAU - Kassimis, George
AU  - Kassimis G
FAU - Davlouros, Periklis
AU  - Davlouros P
FAU - Hahalis, George
AU  - Hahalis G
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20130306
PL  - United States
TA  - Thromb Res
JT  - Thrombosis research
JID - 0326377
SB  - IM
MH  - Blood Platelets/*pathology
MH  - Cohort Studies
MH  - Electrocardiography
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*blood/pathology/surgery
MH  - Percutaneous Coronary Intervention
MH  - Platelet Function Tests
MH  - Predictive Value of Tests
MH  - Prospective Studies
MH  - Thrombosis/*blood/pathology/surgery
MH  - Treatment Outcome
EDAT- 2013/03/14 06:00
MHDA- 2014/02/18 06:00
CRDT- 2013/03/14 06:00
PHST- 2012/12/05 00:00 [received]
PHST- 2013/02/06 00:00 [revised]
PHST- 2013/02/11 00:00 [accepted]
PHST- 2013/03/14 06:00 [entrez]
PHST- 2013/03/14 06:00 [pubmed]
PHST- 2014/02/18 06:00 [medline]
AID - S0049-3848(13)00054-6 [pii]
AID - 10.1016/j.thromres.2013.02.010 [doi]
PST - ppublish
SO  - Thromb Res. 2013 Apr;131(4):333-7. doi: 10.1016/j.thromres.2013.02.010. Epub 2013 
      Mar 6.