• Medicine · Jul 2024

    Observational Study

    Prognostic significance of refractory thrombus in STEMI patients and the role of red cell distribution width: A case-control study.

    • Jianqi Guo, Daoyuan Si, Hongliang Yang, Yaliang Tong, Xingyu Fan, Jinghan Wei, and Yuquan He.
    • Department of Cardiology, Jilin Provincial Engineering Laboratory for Endothelial Function, China-Japan Union Hospital of Jilin University, Changchun, Jilin, China.
    • Medicine (Baltimore). 2024 Jul 12; 103 (28): e38670e38670.

    AbstractThe high thrombus burden of the infarct-related artery (IRA) is associated with the adverse prognosis in ST-segment elevation myocardial infarction (STEMI) patients. Our objectives were to investigate the predictors and evaluate the prognosis of refractory thrombus in STEMI patients. A total of 1305 consecutive patients with STEMI who underwent primary percutaneous coronary intervention (pPCI) were screened. The refractory thrombus group (n = 15) was defined as IRA thrombolysis in myocardial infarction flow < grade 2 after multiple thrombus aspiration (TA). The control group (n = 45) was age- and sex-matched and was selected from the same batch of patients. Baseline hematologic indices were measured before the pPCI. The major adverse cardiovascular events (MACE) were recorded during follow-up. The refractory thrombus group had significantly higher red cell distribution width (RDW) at baseline compared with the control group (13.1 [12.4-13.7] vs 12.6 [12.3-12.8], P = .008). In multivariate logistic regression analysis, RDW was an independent predictor of refractory thrombus (odds ratio: 8.799, 95% CI: 1.240-62.454, P = .030). The area under the receiver-operating characteristic curve of the RDW was 0.730 (95%CI: 0.548-0.912, P = .008). During a mean period of 26 months follow-up, patients in the refractory thrombus group tended to have higher percent MACEs compared with patients in the control group (53.3% vs 6.7%, P < .001). In the present study, we found that the refractory thrombus in STEMI patients was associated with the worse prognosis and the increased RDW might be a potential independent predictor.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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