The Predictors of Spontaneous Coronary Reperfusion in Patients with ST-segment Elevation Myocardial Infarction

Romi Ermawan, Yusra Pintaningrum, Dian Puspita Sari, Yanna Indrayana, Kartika Aprilia

Abstract


BACKGROUND: In ST-segment elevation myocardial infarction (STEMI) management, some patients undergo spontaneous coronary reperfusion (SCR) with a better prognosis than those without SCR, but predictors for SCR remain unclear.

OBJECTIVE: To investigate several potential predictors of SCR, including smoking status, BMI, DAPT loading time, hemoglobin levels, platelet count, random blood sugar levels, uric acid levels, creatinine clearance, and the Syntax score.

METHODS: This case-control study was conducted at the West Nusa Tenggara General Hospital in Indonesia from December 2022 to September 2023. Data collection encompassed various patient demographics and clinical parameters, including name, medical record number, age, gender, smoking status, BMI, DAPT loading time, hemoglobin levels, platelet count, random blood sugar, uric acid, creatinine clearance, the Syntax score, and the occurrence of SCR. Statistical analysis for this study involved multivariate logistic regression analysis.

RESULTS: A total of thirty-two patients was included, evenly divided into 16 subjects allocated to the SCR group and 16 to the non-SCR group. The analysis indicated that only BMI demonstrated a statistically significant association with SCR occurrence. However, the study did not yield conclusive evidence regarding the influence of smoking status, DAPT loading time, hemoglobin levels, platelet count, random blood sugar levels, uric acid levels, creatinine clearance, and the Syntax score on the likelihood of SCR.

CONCLUSION: A normal BMI is identified as a robust predictor for the incidence of SCR in patients diagnosed with STEMI.


Keywords


predictors; spontaneous coronary reperfusion; ST-segment elevation myocardial infarction

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References


Li X, Li B, Gao J, Wang Y, Xue S, Jiang D, et al. Influence of angiographic spontaneous coronary reperfusion on long-term prognosis in patients with ST-segment elevation myocardial infarction. Oncotarget 2017;8:79767-74.

Partow-Navid R, Prasitlumkum N, Mukherjee A, Varadarajan P, Pai RG. Management of ST elevation myocardial infarction (stemi) in different settings. Int J Angiol 2021;30:67-75.

Smith JN, Negrelli JM, Manek MB, Hawes EM, Viera AJ. Diagnosis and management of acute coronary syndrome: an evidence-based update. J Am Board Fam Med 2015;28:283-93.

Wang J, He SY. Clinical and angiographic characteristics of patients with spontaneous reperfusion in ST-segment elevation myocardial infarction. Medicine (Baltimore) 2020;99:e19267.

Guo J, Chen J, Wang G, Liu Z, Niu D, Wu Y, et al. Plaque characteristics in patients with ST-segment elevation myocardial infarction and early spontaneous reperfusion. EuroIntervention 2021;17:e664-e71.

Bainey KR, Fu Y, Granger CB, Hamm CW, Holmes DR, Jr., O'Neill WW, et al. Benefit of angiographic spontaneous reperfusion in STEMI: does it extend to diabetic patients? Heart 2009;95:1331-6.

Zhang K, Yang W, Zhang M, Sun Y, Zhang T, Liu J, et al. Pretreatment with antiplatelet drugs improves the cardiac function after myocardial infarction without reperfusion in a mouse model. Cardiol J 2021;28:118-28.

Vandenbroucke JP, von Elm E, Altman DG, Gotzsche PC, Mulrow CD, Pocock SJ, et al. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Epidemiology 2007;18:805-35.

WMA. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA 2013;310:2191-4.

Wen J, He L, Du X, Ma CS. Body mass index enhances the associations between plasma glucose and mortality in patients with acute coronary syndrome. Diabetes Metab Syndr Obes 2022;15:2675-82.

Limberg JK, Morgan BJ, Schrage WG. Peripheral blood flow regulation in human obesity and metabolic syndrome. Exerc Sport Sci Rev 2016;44:116-22.

Powell-Wiley TM, Poirier P, Burke LE, Despres JP, Gordon-Larsen P, Lavie CJ, et al. Obesity and cardiovascular disease: A scientific statement from the American Heart Association. Circulation 2021;143:e984-e1010.

Campbell DJ, Somaratne JB, Prior DL, Yii M, Kenny JF, Newcomb AE, et al. Obesity is associated with lower coronary microvascular density. PLoS One 2013;8:e81798.

De Luca G, Gibson CM, Bellandi F, Murphy S, Maioli M, Noc M, et al. Early glycoprotein IIb-IIIa inhibitors in primary angioplasty (EGYPT) cooperation: an individual patient data meta-analysis. Heart 2008;94:1548-58.

Sharif D, Abu-Salem M, Sharif-Rasslan A, Rosenschein U. Platelet counts on admission affect coronary flow, myocardial perfusion and left ventricular systolic function after primary percutaneous coronary intervention. Eur Heart J Acute Cardiovasc Care 2017;6:632-9.

Turakhia MP, Murphy SA, Pinto TL, Antman EM, Giugliano RP, Cannon CP, et al. Association of platelet count with residual thrombus in the myocardial infarct-related coronary artery among patients treated with fibrinolytic therapy for ST-segment elevation acute myocardial infarction. Am J Cardiol 2004;94:1406-10.

Mueller C, Neumann FJ, Hochholzer W, Trenk D, Zeller T, Perruchoud AP, et al. The impact of platelet count on mortality in unstable angina/non-ST-segment elevation myocardial infarction. Am Heart J 2006;151:1214 e1-7.

Nikolsky E, Grines CL, Cox DA, Garcia E, Tcheng JE, Sadeghi M, et al. Impact of baseline platelet count in patients undergoing primary percutaneous coronary intervention in acute myocardial infarction (from the CADILLAC trial). Am J Cardiol 2007;99:1055-61.

Kanellis J, Watanabe S, Li JH, Kang DH, Li P, Nakagawa T, et al. Uric acid stimulates monocyte chemoattractant protein-1 production in vascular smooth muscle cells via mitogen-activated protein kinase and cyclooxygenase-2. Hypertension 2003;41:1287-93.

Ruggiero C, Cherubini A, Ble A, Bos AJ, Maggio M, Dixit VD, et al. Uric acid and inflammatory markers. Eur Heart J 2006;27:1174-81.

Esposito K, Nappo F, Marfella R, Giugliano G, Giugliano F, Ciotola M, et al. Inflammatory cytokine concentrations are acutely increased by hyperglycemia in humans: role of oxidative stress. Circulation 2002;106:2067-72.

Sabatine MS, Morrow DA, Giugliano RP, Burton PB, Murphy SA, McCabe CH, et al. Association of hemoglobin levels with clinical outcomes in acute coronary syndromes. Circulation 2005;111:2042-9.

Santopinto JJ, Fox KA, Goldberg RJ, Budaj A, Pinero G, Avezum A, et al. Creatinine clearance and adverse hospital outcomes in patients with acute coronary syndromes: findings from the global registry of acute coronary events (GRACE). Heart 2003;89:1003-8.

Safarian H, Alidoosti M, Shafiee A, Salarifar M, Poorhosseini H, Nematipour E. The SYNTAX score can predict major adverse cardiac events following percutaneous coronary intervention. Heart Views 2014;15:99-105.




DOI: https://doi.org/10.21776/ub/hsj.2024.005.03.6

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