Relationship of Platelet Reactivity and Inflammatory Markers to Recurrent Adverse Events in Patients with ST-Elevation Myocardial Infarction

• DOI: 10.1055/s-0039-1695007
• Publication Date: 2019-08-22T18:46:33Z
• Authors: Krishma Adatia; Mohamed F. Farag; Ying X. Gue; Manivannan Sriniv...; Diana A. Gorog
• Keywords: Mace

Background Patients with ST-elevation myocardial infarction (STEMI) exhibit pro-thrombotic and pro-inflammatory states. Markers of enhanced platelet reactivity inflammation are predictive adverse outcome. However, the relationship between these biomarkers, their combined usefulness for risk stratification, is not clear. Methods In a prospective study 541 patients presenting STEMI, blood samples were taken on arrival to measure high-sensitivity C-reactive protein (hs-CRP), neutrophil/lymphocyte ratio (NLR) using point-of-care Global Thrombosis Test. These alone in combination, related occurrence major cardiovascular events (MACE, defined as composite death, cerebrovascular accident) at 30 days 12 months. Results Platelet hs-CRP, but NLR, weakly MACE The combination raised hs-CRP was strongly (hazard [HR] 3.46 [95% confidence interval [CI] 1.81–6.62], p < 0.001) months (HR CI 1.81–6.63], 0.001). Combination all three biomarkers (NLR, reactivity) provided best prediction 3.73 1.69–8.27], 3.85 1.72–8.60], 0.001), improved when added Thrombolysis Myocardial Infarction score (net reclassification index 0.296, Conclusion A easy arrival, namely NLR reactivity, can help identify STEMI high recurrent over subsequent year.