title: Increased Platelet-leukocyte Aggregates Are Associated With Myocardial No-reflow in Patients With ST Elevation Myocardial Infarction.
abstract: We aimed to investigate the association between platelet-leukocyte aggregates (PLA) levels on admission and the risk of myocardial no-reflow in patients with ST elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI).
  
  
  
  A total of 83 patients with STEMI undergoing primary PCI were included in the current study. Platelet-leukocyte conjugates (PLA), including platelet-monocyte aggregates (PMA), platelet-neutrophil aggregates (PNA) and platelet-lymphocyte aggregates were studied by flow cytometry in peripheral venous blood. No-reflow was defined as coronary blood flow grade thrombolysis in myocardial infarction ≤2 or thrombolysis in myocardial infarction 3 and myocardial blush grade ≤2.
  
  
  
  No-reflow was observed in 19 patients (22.9%). Compared with the reflow group, the level of PNA (76.5 ± 13.3) and PMA (90.3 ± 5.2) before PCI no-reflow group was significantly higher than that in normal reflow (P < 0.001). Using multiple logistic regression analysis, PNA (odds ratio [OR] = 1.179; 95% CI: 1.035-1.342; P = 0.013) and PMA (OR = 1.248; 95% CI: 1.040-1.498; P = 0.017) were found to be a significant predictor of no-reflow together with pain to balloon time (OR = 1.022; 95% CI: 1.002-1.041; P = 0.028), estimated glomerular filtration rate (OR = 1.311; 95% CI: 1.009-1.856; P = 0.047) and higher thrombus burden (OR = 0.061; 95% CI: 0.006-0.658; P = 0.021). Receiver operating characteristic curve analysis revealed that PNA (area under the curve = 0.881; 95% CI: 0.809-0.952; P < 0.001), PMA (area under the curve = 0.794; 95% CI: 0.699-0.889; P < 0.001) have important predictive value for the myocardial no-reflow.
  
  
  
  Our study indicated that preprocedural increased PLA levels display a significantly independent association with no-reflow phenomenon after PCI. Increased PLA levels may predict the development of no-reflow phenomenon in patients with STEMI who underwent PCI.
authors.affiliation: Department of Cardiology, Yuhuangding Hospital, Yantai, Shandong, P.R. China.
authors.forename: Faxin
authors.initials: F
authors.lastname: Ren
authors.affiliation: Department of Gynecology, Yuhuangding Hospital, Yantai, Shandong, P.R. China.
authors.forename: Nan
authors.initials: N
authors.lastname: Mu
authors.affiliation: Department of Clinical Laboratories, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, P.R. China.
authors.forename: Xia
authors.initials: X
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Yuhuangding Hospital, Yantai, Shandong, P.R. China.
authors.forename: Jinxi
authors.initials: J
authors.lastname: Tan
authors.affiliation: Department of Cardiology, Yuhuangding Hospital, Yantai, Shandong, P.R. China.
authors.forename: Liudong
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Cardiology, Yuhuangding Hospital, Yantai, Shandong, P.R. China.
authors.forename: Chuanhuan
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Yuhuangding Hospital, Yantai, Shandong, P.R. China. Electronic address: dongmei0212@126.com.
authors.forename: Mei
authors.initials: M
authors.lastname: Dong
mesh_terms: D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use; D001792:Blood Platelets / Q000378:metabolism / Q000473:pathology*; D000077144:Clopidogrel; D017023:Coronary Angiography; D003326:Coronary Circulation; D003328:Coronary Thrombosis / Q000097:blood / Q000517:prevention & control; D004562:Electrocardiography; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007962:Leukocytes / Q000378:metabolism / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000453:epidemiology / Q000276:immunology / Q000601:surgery; D054318:No-Reflow Phenomenon / Q000097:blood* / Q000453:epidemiology / Q000276:immunology; D062645:Percutaneous Coronary Intervention; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D013988:Ticlopidine / Q000008:administration & dosage / Q000031:analogs & derivatives / Q000627:therapeutic use
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin
keywords: Acute myocardial infarction; Inflammation reaction; No-reflow; Platelet-leukocyte aggregates; Thrombosis