Relationship between blood viscosity and infarct size in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
BACKGROUND
Previous studies explored the association between hemorheological alterations and acute myocardial infarction, pointing out the role of hematological components on microvascular flow. The aim of this study was to evaluate the association between blood viscosity and infarct size, estimated by creatine kinase (CK) peak activity and cardiac Troponin I (cTnI) peak concentration in ST-segment elevation myocardial infarction (STEMI) patients after primary percutaneous coronary intervention (PCI).


METHODS
The study population included 197 patients with diagnosis of STEMI undergoing PCI. Hemorheological studies were performed by assessing whole blood viscosity (measured at shear rates of 0.512 s(-1) and 94.5 s(-1)) and plasma viscosity using the Rotational Viscosimeter LS 30 and erythrocyte deformability index by Myrenne filtrometer.


RESULTS
Significant correlations between CK peak activity, cTnI peak concentration, left ventricular ejection fraction and hemorheological variables were observed. At linear regression analysis (adjusted for age, gender, traditional cardiovascular risk factors, renal dysfunction, timeliness of reperfusion, pre-PCI TIMI flow, infarct location, multivessel disease and previous coronary artery disease) leukocytes and whole blood viscosity at 0.512 s(-1) and 94.5 s(-1) were independently and positively associated with infarct size.


CONCLUSIONS
These results demonstrate a significant and independent association between hemorheology and infarct size in STEMI patients after PCI suggesting that blood viscosity, in a condition of low flow, might worsen myocardial perfusion leading to an increased infarct size. The measurement of whole blood viscosity in STEMI patients could help to identify those who may benefit from new therapeutic strategies.
Cecchi
Emanuele
E
Dipartimento di Area Critica Medico-Chirurgica, Centro Trombosi, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy.
Liotta
Agatina Alessandriello
AA
Gori
Anna Maria
AM
Valente
Serafina
S
Giglioli
Cristina
C
Lazzeri
Chiara
C
Sofi
Francesco
F
Gensini
Gian Franco
GF
Abbate
Rosanna
R
Mannini
Lucia
L
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D001809:Blood Viscosity; D003326:Coronary Circulation; D003402:Creatine Kinase / Q000097:blood; D054855:Drug-Eluting Stents; D004562:Electrocardiography; D005260:Female; D018056:Hemorheology; D006801:Humans; D016014:Linear Models; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000473:pathology / Q000628:therapy; D013318:Stroke Volume; D019210:Troponin I / Q000097:blood; D055815:Young Adult
D015415:Biomarkers; D019210:Troponin I; D003402:Creatine Kinase