Document Detail

Plasma levels of thromboxane A2 on admission are associated with no-reflow after primary percutaneous coronary intervention.
MedLine Citation:
PMID:  18617477     Owner:  NLM     Status:  MEDLINE    
AIMS: Thromboxane A2 (TXA2) is a key mediator of platelet activation and aggregation, and an important mediator of platelet-induced coronary artery constriction. We sought to investigate whether baseline plasma levels of TXA2 are associated with coronary no-reflow after primary percutaneous coronary intervention (PPCI). METHODS AND RESULTS: A total of 47 consecutive patients (age, 62.5 +/- 12.7; male sex, 76.6%) admitted to our hospital for a first ST-segment elevation myocardial infarction and undergoing PPCI within 12 h of onset of symptoms were enrolled. Admission TXA2 plasma levels were measured by enzyme-linked immunosorbent assay (ELISA). Angiographic no-reflow was defined as a final TIMI flow of <or=2 or final TIMI flow of 3 with a myocardial blush grade of <2, whereas ST-segment resolution from baseline value of <or=50% was used as ECG index of no-reflow. At multivariable analysis TXA2 plasma levels, endothelin-1 (ET-1) plasma levels, and left anterior descending coronary artery (LAD) as culprit vessel were significant predictors of angiographic no-reflow (P = 0.04), whereas TXA2 and ET-1 plasma levels were the only independent predictors of lack of ST-segment resolution (P = 0.013 and 0.04, respectively). Of note, TXA2 tertiles were independent predictors of both angiographic no-reflow and lack of ST-segment resolution (OR, 3.5; 95% CI, 1.1-11; P = 0.03 and OR, 3; 95% CI, 1.3-7; P = 0.01, respectively). CONCLUSION: TXA2 is an independent indicator of no-reflow that occurs after PPCI. This observation may open new therapeutic opportunity in the setting of PPCI.
Giampaolo Niccoli; Simona Giubilato; Eleonora Russo; Cristina Spaziani; Andrea Leo; Italo Porto; Antonio M Leone; Francesco Burzotta; Silvia Riondino; Fabio Pulcinelli; Luigi M Biasucci; Filippo Crea
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Publication Detail:
Type:  Journal Article     Date:  2008-07-10
Journal Detail:
Title:  European heart journal     Volume:  29     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-08-04     Completed Date:  2008-12-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  1843-50     Citation Subset:  IM    
Institute of Cardiology, Catholic University of the Sacred Heart, Largo F Vito 1, 00168 Rome, Italy.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*
Biological Markers / blood
Coronary Angiography
Coronary Circulation / drug effects
Endothelin-1 / blood
Enzyme-Linked Immunosorbent Assay
Middle Aged
Myocardial Infarction / blood,  therapy*
No-Reflow Phenomenon / blood*,  etiology
Risk Assessment
Thromboxane A2 / blood*
Treatment Outcome
Reg. No./Substance:
0/Biological Markers; 0/Endothelin-1; 57576-52-0/Thromboxane A2
Comment In:
Eur Heart J. 2008 Aug;29(15):1795-7   [PMID:  18617478 ]

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