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Original research
Association of ectatic non-infarct-related artery with 1-month stent thrombosis in patients with ST elevation myocardial infarction
  1. Gönül Zeren1,
  2. İlhan İlker Avci2,
  3. Mustafa Azmi Sungur1,
  4. Barış Şimşek1,
  5. Aylin Sungur3,
  6. Mehmet Fatih Yılmaz1,
  7. Fatma Can1,
  8. Ufuk Gurkan1,
  9. Can Yücel Karabay1
  1. 1 Department of Cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
  2. 2 Department of Cardiology, İstanbul Dr Siyami Ersek Göğüs Kalp ve Damar Cerrahisi Eğitim ve Araştırma Hastanesi, Istanbul, Turkey
  3. 3 Department of Cardiology, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey
  1. Correspondence to Dr Gönül Zeren, cardiology, Dr Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, 34668 Istanbul, Turkey; gonulzeren{at}hotmail.com

Abstract

Background Ectatic infarct-related artery (IRA) has been shown to be associated with higher thrombus burden, no-reflow, stent thrombosis (ST) and major adverse cardiovascular events in patients with ST-elevation myocardial infarction (STEMI). The effect of ectatic non-IRA on ST without ectatic IRA is not known. We aimed to assess the effect of ectatic non-IRA presence on ST within 1 month after primary percutaneous intervention (pPCI) in patients with STEMI.

Methods A total of 1541 patients with a diagnosis of STEMI and underwent pPCI between 2015 and 2020 were retrospectively included in the study. Patients with and without 1 month ST were compared. Penalised logistic regression method was used to assess the association between ST and candidate predictors due to the risk of overfitting.

Results Median age of the study group was 56.5 (48.7 to 67.2) years. The Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) score, ectatic non-IRA presence and use of tirofiban were significantly higher in the ST group (18.2±9.9 vs 15.1±9.9, p=0.03; 25% vs 7.2%, p<0.001; 54.2% vs 30.5%, p<0.001; respectively). Significantly higher thrombus aspiration (14.3% vs 6.7%, p=0.03) and lower stent implantation (67.7% vs 84%, p<0.001) rates were observed in ectatic IRA group compared with ectatic non-IRA group. In multivariable analysis, ectatic non-IRA presence was independently associated with 1-month ST (OR 4.01, 95% CI 1.86 to 8.63, p=0.01).

Conclusion Ectatic non-IRA presence without ectatic IRA in patients with STEMI increases the risk of ST within the first month of pPCI.

  • myocardial infarction
  • coronary heart disease
  • coronary intervention

Data availability statement

Data are available upon reasonable request.

http://dx.doi.org/10.1136/postgradmedj-2021-141483

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • Contributors GZ, İİA and CYK planned the study. MAS, BŞ, FC and MFY collected the data. CYK analysed the data. GZ and AS performed the literature search and wrote the paper. UG, İİA, GZ and CYK made the critical revision of the paper. All authors have contributed significantly to the manuscript to be published. GZ is the guarantor of the paper.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.