Abstract 15198: Levels of Platelet-Derived Microparticles Are Related to Angiographic No-Reflow Phenomenon in Patients With ST-Elevation Myocardial Infarction Undergoing Primary-PCI
Purpose: Platelet-derived-microparticles (PMP) are fragments ranging 0.1-1 μm, released by platelets and elevated in patients with acute coronary syndromes (ACS). PMP levels are increased in ST-elevation myocardial infarction (STEMI) with higher levels in intracoronary blood drawn from the culprit lesion than in peripheral blood. Aim of our study was to assess if MP are associated with no-reflow (NR), by analyzing correlations of intracoronary and peripheral levels of MP with angiographic score of NR, in particular myocardial blush grade (MBG) and quantitative blush evaluator (QuBE), a new computer-calculated score which is significantly related to MBG, but with a lower inter-observer variability.
Methods: Forty-six STEMI pts treated with primary-percutaneous coronary intervention (pPCI) were enrolled. Intracoronary-translesional blood sample were collected directly from thrombus-aspiration device (Diver CE, Invatec). Peripheral blood sample were collected directly from the guiding catheter at the end of PCI. Blood samples were analyzed on-line by flow-cytometry to detect levels of PMP (CD31+/CD42+). MBG and QuBE were blindly assessed.by two independent operators.
Results: PMP (n/μl) were 36.89 (12.2–167.65) and 16.7 (7.02–76.65) in intracoronary and peripheral blood respectively (p<0.001). MBG 0/1 was present in 11 patients, MBG 2 in 12, MBG3 in 18. QuBE values ranged from 1 to 42.3. Both intracoronary and peripheral PMP were inversely related to MBG (p fro linear trend respectively 0.003 and 0.02) and QuBE (rho −0.75; p<0.001 and rho −0.58; p=0.001, respectively).
Conclusions: In our study, both systemic and intracoronary PMP were strongly related to angiographic indexes of NR. These data strongly suggest that PMP play an important role in determining no reflow.
- © 2010 by American Heart Association, Inc.