Association between inflammation and left ventricular thrombus formation following ST-elevation myocardial infarction
Copyright © 2022 Elsevier B.V. All rights reserved..
BACKGROUND: Current evidence suggests a link between the inflammatory state and left ventricular (LV) thrombus formation following ST-elevation myocardial infarction (STEMI). However, a comprehensive study investigating the association between inflammatory biomarkers and LV thrombus diagnosed by cardiac magnetic resonance (CMR) is lacking.
METHODS: We studied 309 patients with acute STEMI treated with primary percutaneous coronary intervention (pPCI) from the prospective MARINA-STEMI cohort study. Concentrations of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), white blood cell count (WBCc), fibrinogen and D-dimer were measured two days after STEMI. Infarct characteristics and presence of LV thrombi were assessed with the use of contrast-enhanced CMR at a median of 4 (interquartile range [IQR] 3-5) days after pPCI.
RESULTS: In total, 309 STEMI patients (18% female) with a median age of 57 (IQR 52-65) years were included. A LV thrombus was observed in 8% (n = 24) of the overall cohort and in 15% of patients with an anterior STEMI. Hs-CRP (OR 2.16, 95% CI 1.54-3.02, p < 0.001), IL-6 (OR 2.38, 95% CI 1.48-3.81, p < 0.001) and fibrinogen levels (OR 2.05, 95% CI 1.40-3.00, p < 0.001) were significantly associated with presence of LV thrombus. Among all assessed inflammatory biomarkers, only hs-CRP was independently associated with LV thrombus after adjustment for markers of inflammation and CMR parameters (OR 1.77, 95% CI 1.21-2.59, p = 0.004).
CONCLUSION: In patients with STEMI treated with pPCI, inflammatory markers (hs-CRP, IL-6 and fibrinogen) are associated with the presence of LV thrombus. However, only hs-CRP was independently associated with the occurrence of LV thrombi, highlighting the key role of CRP as clinical risk marker for LV thrombus formation in STEMI patients treated with pPCI.
| Errataetall: |
CommentIn: Int J Cardiol. 2022 Oct 1;364:16-17. - PMID 35680057 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:361 |
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| Enthalten in: |
International journal of cardiology - 361(2022) vom: 15. Aug., Seite 1-6 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lechner, Ivan [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 15.06.2022 Date Revised 27.09.2022 published: Print-Electronic CommentIn: Int J Cardiol. 2022 Oct 1;364:16-17. - PMID 35680057 Citation Status MEDLINE |
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| doi: |
10.1016/j.ijcard.2022.05.009 |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM340621192 |
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| 100 | 1 | |a Lechner, Ivan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Association between inflammation and left ventricular thrombus formation following ST-elevation myocardial infarction |
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| 500 | |a Date Completed 15.06.2022 | ||
| 500 | |a Date Revised 27.09.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Int J Cardiol. 2022 Oct 1;364:16-17. - PMID 35680057 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2022 Elsevier B.V. All rights reserved. | ||
| 520 | |a BACKGROUND: Current evidence suggests a link between the inflammatory state and left ventricular (LV) thrombus formation following ST-elevation myocardial infarction (STEMI). However, a comprehensive study investigating the association between inflammatory biomarkers and LV thrombus diagnosed by cardiac magnetic resonance (CMR) is lacking | ||
| 520 | |a METHODS: We studied 309 patients with acute STEMI treated with primary percutaneous coronary intervention (pPCI) from the prospective MARINA-STEMI cohort study. Concentrations of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), white blood cell count (WBCc), fibrinogen and D-dimer were measured two days after STEMI. Infarct characteristics and presence of LV thrombi were assessed with the use of contrast-enhanced CMR at a median of 4 (interquartile range [IQR] 3-5) days after pPCI | ||
| 520 | |a RESULTS: In total, 309 STEMI patients (18% female) with a median age of 57 (IQR 52-65) years were included. A LV thrombus was observed in 8% (n = 24) of the overall cohort and in 15% of patients with an anterior STEMI. Hs-CRP (OR 2.16, 95% CI 1.54-3.02, p < 0.001), IL-6 (OR 2.38, 95% CI 1.48-3.81, p < 0.001) and fibrinogen levels (OR 2.05, 95% CI 1.40-3.00, p < 0.001) were significantly associated with presence of LV thrombus. Among all assessed inflammatory biomarkers, only hs-CRP was independently associated with LV thrombus after adjustment for markers of inflammation and CMR parameters (OR 1.77, 95% CI 1.21-2.59, p = 0.004) | ||
| 520 | |a CONCLUSION: In patients with STEMI treated with pPCI, inflammatory markers (hs-CRP, IL-6 and fibrinogen) are associated with the presence of LV thrombus. However, only hs-CRP was independently associated with the occurrence of LV thrombi, highlighting the key role of CRP as clinical risk marker for LV thrombus formation in STEMI patients treated with pPCI | ||
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| 650 | 4 | |a C-reactive protein | |
| 650 | 4 | |a Cardiac magnetic resonance | |
| 650 | 4 | |a Inflammation | |
| 650 | 4 | |a Left ventricular thrombus | |
| 650 | 4 | |a ST-segment elevation myocardial infarction | |
| 650 | 7 | |a Biomarkers |2 NLM | |
| 650 | 7 | |a Interleukin-6 |2 NLM | |
| 650 | 7 | |a Fibrinogen |2 NLM | |
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| 700 | 1 | |a Reindl, Martin |e verfasserin |4 aut | |
| 700 | 1 | |a Tiller, Christina |e verfasserin |4 aut | |
| 700 | 1 | |a Holzknecht, Magdalena |e verfasserin |4 aut | |
| 700 | 1 | |a Fink, Priscilla |e verfasserin |4 aut | |
| 700 | 1 | |a Plangger, Johannes |e verfasserin |4 aut | |
| 700 | 1 | |a Mayr, Agnes |e verfasserin |4 aut | |
| 700 | 1 | |a Klug, Gert |e verfasserin |4 aut | |
| 700 | 1 | |a Bauer, Axel |e verfasserin |4 aut | |
| 700 | 1 | |a Reinstadler, Sebastian J |e verfasserin |4 aut | |
| 700 | 1 | |a Metzler, Bernhard |e verfasserin |4 aut | |
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