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We assessed the prognostic value of the platelet to lymphocyte ratio (PLR) on in-hospital and long-term major adverse cardiovascular events (MACEs) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) in a large prospective study. Patients (n = 1938) admitted with acute STEMI within 12 hours of symptom onset and who underwent pPCI between January 2010 and January 2015 were followed up for 31.6 ± 16.2 months. During the in-hospital and long-term follow-up period, MACE, the prevalence of stent thrombosis, nonfatal myocardial infarction, and mortality were higher in the third PLR tertile group. A PLR in the third tertile had 2.4-fold increased risk of in-hospital MACE and 2.8-fold risk of long-term MACE. The PLR was significantly and positively correlated with peak creatine kinase MB (CK-MB) levels (r = 0.562, P < .001) and Gensini score (r = 0.408, P < .001). Kaplan-Meier analysis of long-term MACE-free survival revealed a higher occurrence of MACE in the third PLR tertile group compared to the other tertiles. In conclusion, the PLR may be a marker of inflammatory and prothrombotic status and predicted in-hospital and long-term MACE in a population with STEMI., (© The Author(s) 2015.)

We investigated the relationship between epicardial adipose tissue (EAT) and infarct-related artery (IRA) patency before mechanical reperfusion in patients with ST-segment elevation myocardial infarction (STEMI). Patients (n = 640) were divided into 2 groups based on the thrombolysis in myocardial infarction (TIMI) flow grade. Impaired flow was defined as TIMI grades 0, 1, and 2, and normal flow was defined as TIMI 3. On the admission angiography, 65 (10.2%) patients had TIMI 3 flow, and the remaining 575 (89.8%) had TIMI 0, 1, or 2 flow. The impaired flow group patients had a higher incidence of diabetes mellitus (53.7% vs 41.5%, P = .035), higher EAT thickness (5.66 ± 1.84 vs 4.87 ± 2.09 mm, P = .001), and lower ejection fraction (43.1% ± 8.9% vs 47.4% ± 9.1%, P = .025). Multivariate stepwise logistic regression analysis showed that IRA patency was independently associated with EAT thickness (odds ratio [OR] 0.785; 95% confidence interval [CI] 0.712-0.858; P = .001) and neutrophil-lymphocyte ratio (OR 0.815; 95% CI 0.732-0.917; P = .025). Thickness of EAT was an independent predictor of lower TIMI flow in IRA in patients with STEMI., (© The Author(s) 2015.)

Background: Recent studies have suggested ABO blood type locus as an inherited predictor of thrombosis, cardiovascular risk factors, myocardial infarction. However, data is scarce about the impact of non-O blood groups on prognosis in patients with ST-elevation myocardial infarction (STEMI). Therefore, we aimed to evaluate the prognostic importance of non-O blood groups in patients with STEMI undergoing primary percutaneous coronary intervention (pPCI) METHODS: 1835 consecutive patients who were admitted with acute STEMI between 2010 and 2015 were included and followed-up for a median of 35.6months., Results: The prevalence of hyperlipidemia, total cholesterol, LDL, peak CKMB and no-reflow as well as hospitalization duration were higher in patients with non-O blood groups. Gensini score did not differ between groups. During the in-hospital and long-term follow-up period, MACE, the prevalence of stent thrombosis, non-fatal MI, and mortality were higher in non-O blood groups. In multivariate logistic regression analysis, non-0 blood groups were demonstrated to be independent predictors of in-hospital (OR:2.085 %CI: 1.328-3.274 p=0.001) and long term MACE (OR:2.257 %CI: 1.325-3.759 p<0.001). Kaplan-Meier analysis according to the long-term MACE free survival revealed a higher occurrence of MACE in non-O blood group compared with O blood group (p<0.001, Chi-square: 22.810)., Conclusion: Non-O blood groups were determined to be significant prognostic indicators of short- and long-term cardiovascular adverse events and mortality in patients with STEMI undergoing pPCI. In conjunction with other prognostic factors, evaluation of this parameter may improve the risk categorization and tailoring the individual therapy and follow-up in STEMI patient population., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Aim: We investigated the predictive value of monocyte count to HDL ratio (M/H ratio) for stent thrombosis (ST) in ST elevation myocardial infarction (STEMI)., Patients & Methods: 1170 STEMI patients treated with primary PCI were followed-up for a median of 37.2 months., Results: During follow-up, 112 patients were diagnosed as 'definite' ST. The rate of ST was significantly highest in the third M/H ratio tertile. In Cox regression analysis, adjusted for other factors, having an M/H ratio in third tertile had a 2.2-fold increased risk of ST. Kaplan-Meier analysis revealed the higher occurrence of ST in the third tertile compared with others (p <0.001)., Conclusion: M/H ratio as a novel marker of inflammation seemed to be an independent predictor of ST in STEMI patients.

Background: Extensively used lipid-lowering statins have also non-lipid-lowering, pleiotropic effects. Previous studies have demonstrated that a pre-procedural single dose of atorvastatin is associated with reduced peri-procedural myocardial injury., Aim: The aim of the present study was to demonstrate the effect of a single high loading dose (40 mg) of rosuvastatin on peri-procedural myocardial injury., Methods: Two hundred ninety nine statin-naive patients with stable angina and de novo lesions eligible for PCI were randomized to a rosuvastatin-treatment (n = 153) and to a no-treatment (n = 146) group. A 40 mg loading dose of rosuvastatin was administrated 24 h before the PCI. CK-MB and cTnI levels were measured before and 12 h after the procedure., Results: Baseline characteristics were fairly similar between the two arms. The incidence of a CK-MB and cTnI elevation >3x ULN in the rosuvastatin group was significantly lower compared to the control group (0.7% vs. 11.0%, p < 0.001 and 10.5% vs. 39.0%, p < 0.001, respectively). Similarly, the incidence of any CK-MB and cTnI elevation > ULN in the rosuvastatin group was significantly lower compared to the control group (10.5% vs. 34.2%, p < 0.001 and 20.9% vs. 61.6%, p < 0.001, respectively). In addition, CK-MB and cTnI values 12 h after the PCI were significantly lower in the rosuvastatin group compared to the control group (20.13 +/- 7.24 U/L vs. 27.02 +/- 18.64 U/L, p < 0.001 and 0.14 +/- 0.34 ng/ml vs. 0.35 +/- 0.40 ng/ml, p < 0.001, respectively)., Conclusion: A single high loading dose of rosuvastatin reduces the incidence of peri-procedural myocardial necrosis and infarction effectively.