open access

Vol 64, No 9 (2006)
Other
Published online: 2006-10-11
Submitted: 2012-12-28
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Original article
High baseline fibrinogen concentration as a risk factor of no tissue reperfusion in ST-segment elevation acute myocardial infarction treated with successful primary percutaneous coronary intervention

Jarosław Wasilewski, Tadeusz Osadnik, Lech Poloński
Kardiol Pol 2006;64(9):967-972.

open access

Vol 64, No 9 (2006)
Other
Published online: 2006-10-11
Submitted: 2012-12-28

Abstract

Background: In a large group of patients with myocardial infarction, lack of tissue reperfusion following successful recanalisation of the infarct-related epicardial artery is seen. Blood flow in the microcirculation depends not only on structural changes in the microvasculature but also on rheological features of the blood itself. Aim: To investigate the association between baseline fibrinogen concentration and myocardial reperfusion following successful coronary angioplasty. Methodology: In 105 patients with acute ST-segment elevation myocardial infarction, baseline fibrinogen concentration was compared between patients with successful tissue reperfusion (n=79) and with no myocardial reperfusion (n=26) measured as the degree of ST-segment normalisation after successful recanalisation of the infarct-related artery. Results: Baseline fibrinogen concentration was significantly higher in the no-reperfusion group than in the reperfusion group (523±198.02 mg/dl vs 395.56±144.98 mg/dl, p=0.0004). In the overall study population, fibrinogen level correlated positively with maximum creatine kinase MB fraction concentration (r=0.25, p=0.012) and duration of chest pain (r=0.31, p=0.002). Mean fibrinogen concentration was higher in patients with anterior myocardial infarction than in patients with the infarct-related artery other than the left anterior descending artery. The risk of no-reflow phenomenon assessed in multivariate analysis was higher if duration of chest pain was longer (OR=1.46, CI 95% 1.06-2.16, p=0.001) and baseline fibrinogen concentration higher (OR=1.51, CI 95% 1.011-4.58, p=0.021). Conclusions: Baseline fibrinogen concentration following successful mechanical recanalisation of the infarct-related coronary artery is an independent risk factor of a lack of myocardial reperfusion and it positively correlates with maximum creatine kinase MB fraction concentration and duration of chest pain. High fibrinogen concentration may affect rheological parameters of the blood and play an important role in the pathomechanism of myocardial no-reperfusion phenomenon following successful mechanical recanalisation of the infarct-related coronary artery.

Abstract

Background: In a large group of patients with myocardial infarction, lack of tissue reperfusion following successful recanalisation of the infarct-related epicardial artery is seen. Blood flow in the microcirculation depends not only on structural changes in the microvasculature but also on rheological features of the blood itself. Aim: To investigate the association between baseline fibrinogen concentration and myocardial reperfusion following successful coronary angioplasty. Methodology: In 105 patients with acute ST-segment elevation myocardial infarction, baseline fibrinogen concentration was compared between patients with successful tissue reperfusion (n=79) and with no myocardial reperfusion (n=26) measured as the degree of ST-segment normalisation after successful recanalisation of the infarct-related artery. Results: Baseline fibrinogen concentration was significantly higher in the no-reperfusion group than in the reperfusion group (523±198.02 mg/dl vs 395.56±144.98 mg/dl, p=0.0004). In the overall study population, fibrinogen level correlated positively with maximum creatine kinase MB fraction concentration (r=0.25, p=0.012) and duration of chest pain (r=0.31, p=0.002). Mean fibrinogen concentration was higher in patients with anterior myocardial infarction than in patients with the infarct-related artery other than the left anterior descending artery. The risk of no-reflow phenomenon assessed in multivariate analysis was higher if duration of chest pain was longer (OR=1.46, CI 95% 1.06-2.16, p=0.001) and baseline fibrinogen concentration higher (OR=1.51, CI 95% 1.011-4.58, p=0.021). Conclusions: Baseline fibrinogen concentration following successful mechanical recanalisation of the infarct-related coronary artery is an independent risk factor of a lack of myocardial reperfusion and it positively correlates with maximum creatine kinase MB fraction concentration and duration of chest pain. High fibrinogen concentration may affect rheological parameters of the blood and play an important role in the pathomechanism of myocardial no-reperfusion phenomenon following successful mechanical recanalisation of the infarct-related coronary artery.
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Keywords

acute myocardial infarction; no-reflow phenomenon; fibrinogen; primary PCI

About this article
Title

Original article
High baseline fibrinogen concentration as a risk factor of no tissue reperfusion in ST-segment elevation acute myocardial infarction treated with successful primary percutaneous coronary intervention

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 64, No 9 (2006)

Pages

967-972

Published online

2006-10-11

Bibliographic record

Kardiol Pol 2006;64(9):967-972.

Keywords

acute myocardial infarction
no-reflow phenomenon
fibrinogen
primary PCI

Authors

Jarosław Wasilewski
Tadeusz Osadnik
Lech Poloński

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