Enhanced Thrombin Generation Is Associated with Worse Left Ventricular Scarring after ST-Segment Elevation Myocardial Infarction: A Cohort Study.

Autor: Sia CH; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228, Singapore.; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228, Singapore., Tan SH; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228, Singapore., Chan SP; National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228, Singapore.; Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Drive, Singapore 117597, Singapore., Marchesseau S; Savanamed, Calle Gran Vía, 30, Planta 10, 28013 Madrid, Spain., Sim HW; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228, Singapore., Carvalho L; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228, Singapore.; Laboratory of Genetics and Molecular Cardiology, Heart Institute (InCor-HCFMUSP), Sao Paulo 05403-904, Brazil.; Cardiac Department, Ferderal University of Sao Paulo State (UNIFESP), Sao Paulo 05303-000, Brazil., Chen R; Department of Cardiology, Woodlands Health Campus, Tower E, Level 5, Yishun Community Hospital, 2 Yishun Central 2, Singapore 768024, Singapore., Amin NHM; Clinical Research Centre, Sarawak General Hospital, Jalan Hospital, Kuching 93586, Malaysia.; Department of Cardiology, Sarawak Heart Centre, Samarahan Expressway, Kota Samarahan 94300, Malaysia., Fong AY; Clinical Research Centre, Sarawak General Hospital, Jalan Hospital, Kuching 93586, Malaysia.; Department of Cardiology, Sarawak Heart Centre, Samarahan Expressway, Kota Samarahan 94300, Malaysia., Richards AM; Cardiovascular Research Institute, National University of Singapore, Singapore 119228, Singapore.; Christchurch Heart Institute, Department of Medicine, University of Otago, P.O. Box 4345, Christchurch 8140, New Zealand., Yip C; Department of Laboratory Medicine, Main Building, Level 3, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074, Singapore., Chan MY; Department of Cardiology, National University Heart Centre Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 9, Singapore 119228, Singapore.; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 1E Kent Ridge Road, NUHS Tower Block Level 10, Singapore 119228, Singapore.
Jazyk: angličtina
Zdroj: Pharmaceuticals (Basel, Switzerland) [Pharmaceuticals (Basel)] 2022 Jun 06; Vol. 15 (6). Date of Electronic Publication: 2022 Jun 06.
DOI: 10.3390/ph15060718
Abstrakt: Acute myocardial infarction (AMI) is associated with heightened thrombin generation. There are limited data relating to thrombin generation and left ventricular (LV) scarring and LV dilatation in post-MI LV remodeling. We studied 113 patients with ST-segment elevation myocardial infarction (STEMI) who had undergone primary percutaneous coronary intervention (PPCI) ( n = 76) or pharmaco-invasive management (thrombolysis followed by early PCI, n = 37). Endogenous thrombin potential (ETP) was measured at baseline, 1 month and 6 months. Cardiovascular magnetic resonance imaging was performed at baseline and 6 months post-MI. Outcomes studied were an increase in scar change, which was defined as an increase in left ventricular infarct size of any magnitude detected by late gadolinium enhancement, adverse LV remodeling, defined as dilatation (increase) of left ventricular end-diastolic volume (LVEDV) by more than 20% and an increase in left ventricular ejection fraction (LVEF). The mean age was 55.19 ± 8.25 years and 91.2% were men. The baseline ETP was similar in the PPCI and pharmaco-invasive groups (1400.3 nM.min vs. 1334.1 nM.min, p = 0.473). Each 10-unit increase in baseline ETP was associated with a larger scar size (adjusted OR 1.020, 95% CI 1.002-1.037, p = 0.027). Baseline ETP was not associated with adverse LV remodeling or an increase in LVEF. There was no difference in scar size or adverse LV remodeling among patients undergoing PPCI vs. pharmaco-invasive management or patients receiving ticagrelor vs. clopidogrel. Enhanced thrombin generation after STEMI is associated with a subsequent increase in myocardial scarring but not LV dilatation or an increase in LVEF at 6 months post-MI.
Databáze: MEDLINE
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