Cohort study
Prognostic impact of hypercoagulability and impaired fibrinolysis in acute myocardial infarction
- Prospective registry cohort study
- consecutive patients
- single-centre registry
Authors' conclusion
AMI occurrence is significantly associated with hypercoagulability and impaired fibrinolysis. Their combined phenotype increases the risk of post-PCI atherothrombotic event only in AMI patients.
Study context
- Population
- Consecutive patients undergoing percutaneous coronary intervention (PCI) with thrombogenicity indices measured by thromboelastography
- Participants
- 2,705 patients
- Exposure
- Acute myocardial infarction (AMI) vs non-AMI
- Outcome
- MACE:
- CV death
- Non-fatal MI
- Non-fatal stroke
- Follow-up
- Up to 4 years
Main finding
As reported in the abstract
Post-PCI MACE with combined phenotype MA ≥68 mm and LY30 <0.2%
Each group vs Non-AMIAdjusted hazard ratio (95% CI)P value
AMIcombined phenotype vs without, AMI
1.744(1.135–2.679)
P = 0.011Non-AMIcombined phenotype vs without, non-AMI
1.031(0.499–2.129)
P = 0.935Observational data: associations, not effects.
Further findings
Platelet-fibrin clot strength (MA)
P < 0.001
Fibrinolytic activity (LY30)
P < 0.001
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Association of index AMI presentation with MA and LY30 — AMI · per 1-mm increase in MA | 1.024 (1.013–1.036) | P < 0.001 | |
| Association of index AMI presentation with MA and LY30 — AMI · per 1% increase in LY30 | 0.934 (0.893–0.978) | P = 0.004 | |
| 0.512Odds ratio (log scale) |
Original publication
Prognostic impact of hypercoagulability and impaired fibrinolysis in acute myocardial infarction. Eur Heart J. Published 1 March 2023. doi:10.1093/eurheartj/ehad088
Summarised from the published abstract; every number is checked against it