1499 Poster Cat: 13

INTRACORONARY THROMBUS AGE AND HOSPITAL OUTCOME OF PATIENTS WITH ACUTE CORONARY SYNDROME WITH ST SEGMENT ELEVATION

F. Bosa Ojeda1, G. Yanes Bowden1, A. Sanchez-Grande Flecha1, M.J. Vargas Torres1,

C. Hernandez Garcia1, J.J. Ferrer Hita1, A. Rodriguez Gonzalez1,

M.D. Ravina Cabrera2, R.A. Juarez Prera1, C. Enjuanes Grau1

1Cardiology Dept., Hospital Universitario de Canarias, La Laguna, Santa Cruz de Tenerife, 2Pathology Dept., Hospital Universitario de Canarias, La Laguna,

Santa Cruz de Tenerife, Spain

Introduction: The older thrombus obtained by aspiration thrombectomy (AT) in patients with acute coronary syndrome with ST segment elevation (STEMI) has proven to be an independent predictor of long-term mortality. Our objective was to analyze its relationship with hospital outcome in patients with STEMI.

Methods: A prospective analysis of 61 patients with STEMI that underwent AT during primary percutaneous coronary intervention. Thrombi samples were processed with conventional techniques of hematoxylin-eosin and Masson and immunohistochemistry for CD68. The sample was divided into two groups depending on the age of the thrombus (recent - less than one day old or older - more than one day). We analyzed the hospital outcome expressed as cardiovascular mortality (CVM), heart failure (HF) or a combination of both. Qualitative variables were analyzed with Fischer's exact test and quantitative variables with the Mann-Whitney. Independent predictors were analyzed in a multivariate model.

Results: 43 patients had fresh thrombus against 18 that had older. No differences in baseline characteristics or the type of infarction, time of evolution and ejection fraction. Female gender was associated with increased hospital mortality (p = 0.02), while the anterior location of infarction was associated with IC (p = 0.03) and with the combination of CVM and IC (p <0.01). The presence of older thrombus was associated with IC during hospitalization (p = 0.05). None of the three proved to be an independent predictor.

Conclusions: The presence of old thrombi after AT was associated with a worse hospital outcome of STEMI despite a successful revascularization.