Impact of Initial Platelet Count on Baseline Angiographic Finding in Patients with Acute ST- Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Abstract
Background: Platelets play an important role in cardio-vascular disease both in the pathogenesis of atherosclerosis and in the development of acute thrombotic events. Rupture of atheromatous plaque and subsequent occlusive thrombus formation are believed to be responsible for most acute myocardial ischemic events.
Aim of Study: The aim of this study is to assess the relation and effect of initial platelet count on baseline angiographic findings in patients presented with acute ST Segment Elevation Myocardial Infraction (STEMI) undergoing Primary Percuta-neous Coronary Intervention (pPCI).
Patients and Methods: This study was conducted at the Department of Cardiovascular Medicine, Tanta University Hospital at the period between June 2017 to December 2017, It was carried out on 150 patients diagnosed definitively with acute STEMI and treated with pPCI. Blood samples were collected from the patient on admission to show initial platelet count before coronary intervention followed by assessment of the angiographic findings before wiring of the infract related artery by TIMI flow grade system and scoring of the coronary anatomy with SYNTAX score.
The patients were divided into two groups, group (1): Included patients who had TIMI flow grade 0 (82 patients) representing 54.7% and group (2): Patients who had TIMI flow grade 1-3 (68 patients) 45.3%.
Results: Group (1) who showed total occlusion of infract related artery (TIMI 0) patients had higher initial platelet count with a mean of (255.74±72.01) X 103/mm3 compared to group (2) (TIMI 1-3) in which patients had lower initial platelet count with a mean of (194.94±47.54) X 103/mm3. There was no significant difference between the two groups as regarding of complexity of coronary arteries anatomy calculated by SYNTAX score.
Conclusion: Initial platelet count in patients presented with acute STEMI had a role in predicting pre-interventional angiographic findings, higher initial platelet count is associated with higher incidence of total occlusion of infract related artery in STEMI patients treated with primary PCI, there was no significant relation between initial platelet count and SYNTAX score grade, initial platelet count alone has no effect on SYNTAX flow grade of coronary arteries. It seems that it is affected by multiple risk factors.