Plasma levels of thromboxane A2 on admission are associated with no-reflow after primary percutaneous coronary intervention

Francesco Burzotta, Luigi Marzio Biasucci, Filippo Crea, Giampaolo Niccoli, Simona Giubilato, Eleonora Russo, Cristina Spaziani, Andrea Leo, Italo Porto, Antonio Maria Leone, Silvia Riondino, Fabio Pulcinelli

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59 Citazioni (Scopus)

Abstract

AIMS: Thromboxane A2 (TXA2) is a key mediator of platelet activation and aggregation, and an important mediator of platelet-induced coronary artery constriction. We sought to investigate whether baseline plasma levels of TXA2 are associated with coronary no-reflow after primary percutaneous coronary intervention (PPCI). METHODS AND RESULTS: A total of 47 consecutive patients (age, 62.5 +/- 12.7; male sex, 76.6%) admitted to our hospital for a first ST-segment elevation myocardial infarction and undergoing PPCI within 12 h of onset of symptoms were enrolled. Admission TXA2 plasma levels were measured by enzyme-linked immunosorbent assay (ELISA). Angiographic no-reflow was defined as a final TIMI flow of <or=2 or final TIMI flow of 3 with a myocardial blush grade of <2, whereas ST-segment resolution from baseline value of <or=50% was used as ECG index of no-reflow. At multivariable analysis TXA2 plasma levels, endothelin-1 (ET-1) plasma levels, and left anterior descending coronary artery (LAD) as culprit vessel were significant predictors of angiographic no-reflow (P = 0.04), whereas TXA2 and ET-1 plasma levels were the only independent predictors of lack of ST-segment resolution (P = 0.013 and 0.04, respectively). Of note, TXA2 tertiles were independent predictors of both angiographic no-reflow and lack of ST-segment resolution (OR, 3.5; 95% CI, 1.1-11; P = 0.03 and OR, 3; 95% CI, 1.3-7; P = 0.01, respectively). CONCLUSION: TXA2 is an independent indicator of no-reflow that occurs after PPCI. This observation may open new therapeutic opportunity in the setting of PPCI.
Lingua originaleEnglish
pagine (da-a)1843-1850
Numero di pagine8
RivistaEuropean Heart Journal
DOI
Stato di pubblicazionePubblicato - 2008

Keywords

  • no-reflow
  • platelets

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