Association between inflammatory mediators and angiographic morphologic features indicating thrombus formation in patients with acute myocardial infarction

作     者：LI Dong-bao HUA Qi LIU Zhi LI Jing XU Li-qing WANG Shan JIN Wei-ying 

作者机构：Department of Cardiology Xuanwu Hospital of Capital Medical University Beijing 100053 China 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2009年第122卷第15期

页      面：1738-1742页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

基　　金：This study was supported by a grant from the Beijing Municipal Natural Science Foundation (No. 7072032) 

主　　题：acute myocardial infarction thrombosis neutrophil percutaneous coronary intervention C-reactive protein 

摘      要：Background Inflammatory mechanisms had played an important role in the occurrence and prognosis of acute myocardial infarction, inflammatory mediators was associated with adverse outcomes of acute myocardial infarction. This study tested the hypothesis that in the acute phase of myocardial infarction with ST-segment elevation, neutrophil count and high-sensitivity C-reactive protein are predictive of angiographic morphologic features that indicate thrombus formation in the infarct-related artery. Methods This retrospective study included 182 consecutive patients with acute myocardial infarction and ST-segment elevation. Patients were assigned to a thrombus-formation group （n=77） and a non-thrombus-formation group （n=-106）. All patients had a Killip＇s classification 〈3 and onset 〈12 hours prior to presentation. All the cases were going to undergo coronary angiography, including primary percutaneous coronary intervention, simple coronary angiography, or thrombolysis in a coronary artery （or arteries） or coronary artery bypass graft（s）. Blood samples for measurement of high-sensitivity C-reactive protein and for routine blood laboratory studies were collected prior to coronary angiography. Results The levels of high-sensitivity C-reactive protein, total leukocyte counts, neutrophil counts, and neutrophil/ lymphocyte ratios were substantially higher in the thrombus-formation group than in the non-thrombus-formation group patients （for each, P 〈0.05）. Stepwise Logistic regression analyses identified high-sensitivity C-reactive protein, neutrophil count, and neutrophil/lymphocyte ratio as independent predictors of thrombus formation in the infarct-related artery （for each, P 〈0.05）. Conclusions In patients with acute myocardial infarction levels of high-sensitivity C-reactive protein are predictors to higher neutrophil counts, neutrophil/lymphocyte ratio, and ndicate thrombus formation