Nesrine Amdouni1, Ikram Chamtouri1, Asma Ben Abdallah1, Walid Jomaa1, Khaldoun Ben Hamda1, Faouzi Maatouk1
1CHU FAttouma Bourguiba Monastir, Monastir, Tunisia
The presence of residual intracoronary thrombus after primary percutaneous coronary intervention (PCI) has poor clinical and angiographic outcomes.
Aim: to assess the frequency of residual intracoronary thrombus after PCI for acute myocardial infarction (AMI), its determinants and clinical impact.
We retrospectively included 352 patients with AMI who underwent primary PCI, enrolled between January 2000 and March 2017 in Cardiology B department. We compared clinical and angiographic features of patients who had post PCI angiography visible intracoronary thrombus with those who did not.
Residual intracoronary thrombus after primary PCI for AMI was present in 54 (15.3%) patients. It was more likely to be present in elderly patients (>75 years) (20% vs 14.8%, p=0.025). There was no significant difference between male and female (15.2% vs 16.1%, p=0.5). Patients who had residual intracoronary thrombus following primary PCI had more comorbidities such us hypertension (20.2% vs 13.3%, p=0.032), diabetes mellitus (17.4% vs 14.3%, p= 0.2(NS)), history of coronary disease (25.6% vs 13.6%, p= 0.02) and renal failure (26.8% vs 13%, p= 0.023). They were more likely to be smokers (17.3% vs 12.8%, p=0.01) and anemic (22.6% vs 11%, p=0.03). Higher rate of no reflow was found in 47.2% patients vs 6.3%, p<0.0001. There was more intra hospital mortality (31.5% vs 8.4%, p<0.0001).
Intracoronary thrombus after primary PCI is associated with worse cardiovascular outcomes. However, differences in outcomes between patients with and without residual thrombus are related to baseline clinical differences rather than thrombus per se.