title: Relationship between blood viscosity and infarct size in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
abstract: 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.
authors.affiliation: Dipartimento di Area Critica Medico-Chirurgica, Centro Trombosi, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Cecchi
authors.forename: Agatina Alessandriello
authors.initials: AA
authors.lastname: Liotta
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Gori
authors.forename: Serafina
authors.initials: S
authors.lastname: Valente
authors.forename: Cristina
authors.initials: C
authors.lastname: Giglioli
authors.forename: Chiara
authors.initials: C
authors.lastname: Lazzeri
authors.forename: Francesco
authors.initials: F
authors.lastname: Sofi
authors.forename: Gian Franco
authors.initials: GF
authors.lastname: Gensini
authors.forename: Rosanna
authors.initials: R
authors.lastname: Abbate
authors.forename: Lucia
authors.initials: L
authors.lastname: Mannini
mesh_terms: 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
chemical_list: D015415:Biomarkers; D019210:Troponin I; D003402:Creatine Kinase