Clinical Characteristics And Risk Factors Of High Coronary Artery Thrombotic Burden In Patients With STEMI

Objective:To study the clinical characteristics and risk factors of high coronary artery thrombotic burden in patients with STEMI Methods:210 patients with STEMI admitted to our emergency department in2021 were randomly enrolled in.The degree of thrombus burden was determined according to the angiography results.Divided into low thrombus burden group 110 cases and high thrombus burden group 114 cases.The laboratory examination and relevant parameters of angiography results of the two groups were collected.All factors that might predict the degree of thrombus burden in STEMI patients were evaluated by logistic regression analysis and ROC curve.Results:1、Age,sex ratio,triglycerides,LDL-c,platelets,and creatinine were not statistically significantly different between the high thrombotic burden group and the low thrombotic burden group（P > 0.05）,while the proportion of smoking history,diabetes history,WBC count,and neutrophil count were higher in the high thrombotic burden group than in the low thrombotic burden group,and the differences were statistically significant（P < 0.05）.2、Patients with high thrombotic burden have higher incidence of no-reflow（P < 0.05）.3、 Binary logistic regression analysis of risk factors associated with high coronary thrombus burden suggested that smoking history and WBC count were risk factors for coronary thrombus burden（smoking history: OR=2.206,95%CI 1.042-4.672,P=0.039;WBC count.2.833,95%CI 1.894-4.237,P<0.001）.4.、The area under the ROC curve for WBC count predicting coronary hyperthrombotic burden in STEMI patients was 0.806,（95%CI 0.745-0.868,P<0.001）,and the best threshold value was 9.93*10^9/L,at which the sensitivity was 0.803 and the specificity was 0.679.Conclusion:1、In high thrombotic burden group,leukocyte count and neutrophil count increased significantly,suggesting that inflammatory reaction is involved in the process of AMI,and blood stasis may be involved in the pathophysiological process of high thrombotic load.2、The probability of no reflow in the high thrombotic burden group were higher,suggesting that high coronary thrombotic burden is related to poor prognosis.3、History of smoking and elevated leukocyte count can be risk factors for coronary hyperthrombotic burden in STEMI patients.4,Leukocyte count9.93*10^9/L is a helpful、effective cut-off value for predicting coronary hyperthrombotic burden in STEMI patients.