Biomarkers of Thrombotic Status Predict Spontaneous Reperfusion in Patients With ST-Segment Elevation Myocardial Infarction

<p>Biomarkers of Thrombotic Status Predict Spontaneous Reperfusion in Patients With ST-Segment Elevation Myocardial Infarction   <a href="https://doi.org/10.1016/j.jacc.2023.03.388">https://doi.org/10.1016/j.jacc.2023.03.388</a> </p> <p> Abstract Background: Spontaneous <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/reperfusion">reperfusion</a>, seen in ∼20% of patients with ST-segment elevation myocardial infarction (STEMI), manifests as normal epicardial flow in the infarct-related artery, with or without ST-segment resolution, before <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/percutaneous-coronary-intervention">percutaneous coronary intervention</a> (PCI). The drivers mediating this are unknown.</p> <p> Objectives:</p> <p>The authors sought to relate spontaneous <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/reperfusion">reperfusion</a> to the thrombotic profile.</p> <p><br></p> <p>Methods:</p> <p>In a prospective study, blood from STEMI patients (n = 801) was tested pre-PCI to assess in vitro<em>,</em> point-of-care, occlusion times (OT) and endogenous lysis times (LT). Spontaneous reperfusion was defined as infarct-related artery <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/blood-clot-lysis">Thrombolysis</a> In Myocardial Infarction flow grade 3 before PCI. Patients were followed for major cardiovascular events (death, myocardial infarction, or stroke).</p> <p><br></p> <p>Results:</p> <p>Spontaneous reperfusion was associated with a longer OT (435 seconds vs 366 seconds; <em>P</em> &lt; 0.001) and a shorter LT (1,257 seconds vs 1,616 seconds; <em>P</em> &lt; 0.001), lower <a href="https://www.sciencedirect.com/topics/nursing-and-health-professions/troponin">troponin</a>, and better <a href="https://www.sciencedirect.com/topics/medicine-and-dentistry/heart-left-ventricle-function">left ventricular function</a>. LT was superior to OT for predicting spontaneous reperfusion (area under the curv