title: Hypercoagulation assessed by thromboelastography is neither related to infarct size nor to clinical outcome after primary percutaneous coronary intervention.
abstract: OBJECTIVE
  We investigated the relationship between coagulation assessed by thromboelastography (TEG) and myocardial damage in ST-segment elevation myocardial infarction (STEMI).
  
  
  METHODS
  We measured platelet activity with TEG-maximum amplitude (TEG-MA) in 233 patients undergoing urgent percutaneous coronary intervention (PCI). Infarct size and myocardial salvage index were evaluated using cardiac magnetic resonance, and the relation of these parameters to posttreatment coagulation was examined retrospectively. Adverse events were adjudicated and related to the coagulation status during the index event.
  
  
  RESULTS
  Hypercoagulation was found in 82 (35.2%) patients and was neither correlated to infarct size nor correlated to myocardial salvage index (P = .28 and .65, respectively) or clinical adverse events. Patients who experienced an adverse event during follow-up had a slightly higher TEG-MA value than patients with an event-free follow-up, but this was not statistically significant (68.1 vs 67.3, P = .44).
  
  
  CONCLUSIONS
  The TEG-MA does not appear to be a sensitive predictor of reperfusion success and prognosis in urgent PCI for STEMI.
authors.affiliation: Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark npdridi@gmail.com.
authors.forename: Nadia Paarup
authors.initials: NP
authors.lastname: Dridi
authors.affiliation: Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Jacob T
authors.initials: JT
authors.lastname: Lønborg
authors.affiliation: Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Maria D
authors.initials: MD
authors.lastname: Radu
authors.affiliation: Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Peter
authors.initials: P
authors.lastname: Clemmensen
authors.affiliation: Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Engstrøm
authors.affiliation: Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Henning
authors.initials: H
authors.lastname: Kelbæk
authors.affiliation: Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Erik
authors.initials: E
authors.lastname: Jørgensen
authors.affiliation: Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Steffen
authors.initials: S
authors.lastname: Helqvist
authors.affiliation: Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Kari
authors.initials: K
authors.lastname: Saunamäki
authors.affiliation: Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Troels H
authors.initials: TH
authors.lastname: Christensen
authors.affiliation: Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Florian M M
authors.initials: FM
authors.lastname: Baeres
authors.affiliation: Section for Transfusion Medicine, Capital Region Blood Bank, Department of Clinical Immunology, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Pär I
authors.initials: PI
authors.lastname: Johansson
authors.affiliation: Department of Cardiology, Rigshospitalet, University of Copenhagen, Denmark.
authors.forename: Lene
authors.initials: L
authors.lastname: Holmvang
mesh_terms: D000368:Aged; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000628:therapy*; D062645:Percutaneous Coronary Intervention; D013916:Thrombelastography / Q000379:methods*; D019851:Thrombophilia / Q000175:diagnosis*
keywords: TEG; acute myocardial infarction; area at risk; cardiac magnetic resonance; hyper coagulation; salvage index