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Relationship Between Blood Viscosity and Infarct Size in Patients With ST-Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

According to a 2008 study by Cecchi et al., there is a significant and independent association between blood viscosity and infarctsize in ST-segment elevation myocardial infarction (STEMI) patients after undergoing percutaneous coronary intervention (PCI). The results suggest that hyperviscosity might worsen myocardial perfusion and therefore increase infarct size because blood flow is drastically reduced in the vessel, depriving tissue of oxygen. Infarct size was estimated by peak activity of creatine kinase (CK), an enzyme involved in muscle degradation, and cardiac Troponin I (cTnI), a marker of cardiomuscular degradation, in STEMI patients after they received PCI. Blood viscosity (measured at shear rates of 0.512 s− 1 and 94.5 s− 1) and plasma viscosity were studied in 197 patients with diagnosis of STEMI undergoing PCI.

Significant correlations between CK peak activity, cTnI peak concentration, and whole blood viscosity were observed (p < 0.05 for all). A significant decrease in left ventricular ejection fraction was also observed with hyperviscosity (p < 0.05). After linear regression analysis (adjusted for age, gender, traditional cardiovascular risk factors, renal dysfunction, timeliness of reperfusion, pre-PCI TIMI flow, infarct location, multivessel disease, and previous coronary artery disease), it was found that leukocytes and whole blood viscosity were independently and positively associated with infarct size. Based on these results, whole blood viscosity measurements could improve risk stratification and guide therapeutic strategies in STEMI patients.


Reference:

Cecchi E, Liotta AA, Gori AM, et al. Relationship between blood viscosity and infarct size in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Int J Cardiol. May 15 2009;134(2):189-194.

 

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