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Akbarzadeh, Mohammad Ali
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Medicine & Pharmacology

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Journal : International Journal of Cardiovascular Practice

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Correlation of platelet indices with TIMI frame count in patients undergoing primary PCI due to ST-segment elevation myocardial infarction Salehi, Ayoub; Namazi, Mohammad Hasan; Safi, Morteza; Vakili, Hossein; Saadat, Habibollah; Alipour Parsa, Saeed; Akbarzadeh, Mohammad Ali; Moshtaghi, Ameneh; Khaheshi, Isa
International Journal of Cardiovascular Practice Vol 4, No 3 (2019)
Publisher : International Journal of Cardiovascular Practice

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Abstract

Introduction: Given the fundamental role of platelet indices in the development of atherosclerotic plaque, these indices may play a predictive role for the occurrence of disturbed coronary reperfusion. The present study evaluated the relationship between platelet indices and coronary reperfusion status based on TIMI frame count.Methods: This cross-sectional study was conducted on 98 consecutive patients with STEMI who were candidate for primary PCI at Modarres Hospital in Tehran between January 2016 and January 2018. Venous samples were extracted from all patients before primary PCI. To assess the condition of coronary reperfusion after primary PCI, TIMI frame count related to culprit artery in acute myocardial infarction was determined.Results: The TIMI frame count was positively associated with platelet count (r = 0.320, p = 0.001) and more strongly with platelet to lymphocyte ratio (r = 0.375, p < 0.001), but not with other platelet indices such as PDW, MPV, or PLCR. According to the ROC curve analysis, platelet to lymphocyte ratio was introduced as a valuable parameter for differentiating complete from disturbed reperfusion (AUC = 0.735, 95%CI: 0.613 ? 0.858, P = 0.001). The best cutoff value for platelet to lymphocyte ratio in predicting disturbed reperfusion was 146.5 yielding a sensitivity of 81.8% and a specificity of 60.5%. However, other platelet indices could not present this predictive role.        Conclusion: From different platelet indices, the platelet to lymphocyte ratio with predictive accuracy and sensitivity predict coronary perfusion impairment based on the increase in TIMI frame count.
CARDIOGENIC SHOCK FOLLOWING ACUTE MYOCARDIAL INFARCTION: A RETROSPECTIVE OBSERVATIONAL STUDY Sadeghi, Roxana; Kachoueian, Naser; Maghsoomi, Zohreh; Sistanizad, Mohammad; Soroureddin, Zahra; Akbarzadeh, Mohammad Ali
International Journal of Cardiovascular Practice Article in Press
Publisher : International Journal of Cardiovascular Practice

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Introduction: Cardiogenic shock is a sudden complication that occurs in 5 to 10% of patients with acute myocardial infarction. According to statistics, mortality and morbidity from this event, despite all hospital care, are approximately 70-80%.Methods: This study was conducted over three years (2012 to 2014) in 28 cases of acute myocardial infarction, which was complicated by cardiovascular shock, before or after admission. We compared the outcomes of patients according to the treatment strategy, thrombolytic therapy, primary percutaneous coronary intervention (PCI), or other medical stabilization. The 30-day follow-up was the first endpoint, and the 3- month follow up was the second endpoint of the study.Results: 28 patients with cardiogenic shock included in this study. The mean (± SD) age of the patients was 62.99 ± 13.99 years. The median time to the onset of shock was 648.75 ± 1393.58 minutes after infarction. Most of the patients who underwent coronary angiography had 3-vessel or left main involvement. Two patients missed in follow up and five (80%) patients who received thrombolytic therapy passed away. Nine (100%) patients in the medical stabilization group and six patients (50%) underwent primary PCI group passed away too. The mortality in the primary PCI group was significantly lower than the other groups (P = 0.04).Conclusion: Although cardiogenic shock is a potential risk of early death, it is important that the thrombolytic in these patients doesn't increase survival and the primary PCI is more effective than thrombolytic agents.
Co-Authors Alipour Parsa, Saeed Kachoueian, Naser Khaheshi, Isa Maghsoomi, Zohreh Moshtaghi, Ameneh Namazi, Mohammad Hasan Saadat, Habibollah Sadeghi, Roxana Safi, Morteza Salehi, Ayoub Sistanizad, Mohammad Soroureddin, Zahra Vakili, Hossein