Background: Patients with acute ST-elevation myocardial infarction (STEMI) and increased platelet count treated by fibrinolysis have worse outcome.
Aim: Evaluate effects of platelet count after primary percutaneous coronary intervention (PPCI) on coronary flow, myocardial perfusion and left ventricular systolic function.
Methods: 174 patients presenting with acute anterior STEMI and treated with PPCI were included and divided into subgroups of admission platelet blood count of <200K, 200-300K, 300-400K and >400K. Evaluation of coronary artery flow and myocardial blush grade (MBG) was performed according to the TIMI criteria. Electrocardiographic ST-elevation resolution post-PPCI was evaluated. Doppler echocardiographic evaluation of left anterior descending coronary artery (LAD) velocities early and late after PPCI and assessment of left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) of LV and LAD territory were performed.
Results: Post-PPCI TIMI, MBG were similar in all groups. Lower the platelet count was associated with more frequent complete ST-elevation resolution. Patients with platelet count 400k presented with worse LVEF, LVWMSI and LADWMSI and before discharge this subgroup had LVWMSI and LADWMSI, PConclusions: Patients with anterior STEMI treated by PPCI with lower admission platelet count had higher LAD diastolic velocities, better myocardial perfusion with more patients having LAD-DDT >600ms. Patients with higher platelet counts had lower LV systolic function both at admission and before discharge.
