Department of Cardiology, University of Health Sciences, Mehmet Akif İnan Research and Training Hospital, Sanlíurfa, Turkey.
Republic of Turkey Ministry of Health Siverek State Hospital, Cardiology Department, Sanlíurfa, Turkey.
Clin Hemorheol Microcirc. 2023;85(1):31-40. doi: 10.3233/CH-231756.
İncreased whole blood viscosity (WBV) is associated with increased infarct area, impaired microvascular circulation and mortality in patients with ST-elevation myocardial infarction (STEMI).
We aimed to analyze the association between the WBV and thrombus burden (TB) in STEMI patients.
This cross-sectional study included 167 STEMI patients who received primary percutaneous coronary intervention. WBV values were assessed using hematocrit and total protein values, and low shear rate(LSR) and high shear rate(HSR) were calculated. Angiographic TB was assessed according to the definition of the Thrombolysis in Myocardial Infarction (TIMI) study group. The cases were dichotomized into low TB (grade 1-3) (n = 87) and high TB (grade 4-5) (n = 80) groups.
The mean HSR and LSR values of the high TB group were significantly increased compared to the low TB group (p < 0.001, for each). In ROC analysis,for prediction of TB, a cut-off value of 3.83 WBV for HSR had a 71% sensitivity and a 60.7% specificity, and a cut-off value of 21 WBV for LSR had a 70% sensitivity and 59.9% specificity (p < 0.001,for each). Multivariate regression analysis showed that both HSR (OR = 2.408;p=0.020) and LSR (OR = 1.055;p=0.021) were independent predictors for high TB.
İncreased WBV was an independent predictor for the presence of high TB in patients with STEMI.
全血黏度（WBV）升高与 ST 段抬高型心肌梗死（STEMI）患者梗死面积增大、微血管循环受损和死亡率升高有关。
本研究旨在分析 STEMI 患者的 WBV 与血栓负荷（TB）之间的关系。
本横断面研究纳入了 167 例接受直接经皮冠状动脉介入治疗的 STEMI 患者。通过红细胞压积和总蛋白值评估 WBV 值，并计算低切变率（LSR）和高切变率（HSR）。根据血栓溶解治疗心肌梗死（TIMI）研究组的定义评估血管造影 TB。根据 TB 将病例分为低 TB（1-3 级）（n=87）和高 TB（4-5 级）（n=80）两组。
与低 TB 组相比，高 TB 组的 HSR 和 LSR 值均显著升高（p<0.001，均为）。在 ROC 分析中，预测 TB 时，HSR 的截断值为 3.83 WBV 时具有 71%的敏感性和 60.7%的特异性，LSR 的截断值为 21 WBV 时具有 70%的敏感性和 59.9%的特异性（p<0.001，均为）。多变量回归分析显示，HSR（OR=2.408；p=0.020）和 LSR（OR=1.055；p=0.021）均是高 TB 的独立预测因素。
在 STEMI 患者中，WBV 升高是高 TB 的独立预测因素。
