Regular Article Thrombogenic potential of whole blood is higher in patients with acute coronary syndrome than in patients with stable coronary diseases Koshi Matsuo, Yasunori Ueda ⁎, Mayu Nishio, Akio Hirata, Mitsutoshi Asai, Takayoshi Nemoto, Kazunori Kashiwase, Kazuhisa Kodama Cardiovascular Division, Osaka Police Hospital, Osaka, Japan abstract article info Article history: Received 10 September 2010 Received in revised form 31 January 2011 Accepted 2 April 2011 Available online 4 May 2011 Keywords: Thrombogenic potential of blood Acute coronary syndrome Whole blood Introduction: Although thrombogenic potential of blood may play an important role for the onset of acute coronary syndrome (ACS), there is no established way to evaluate it by single parameter. We compared the thrombogenic potential of whole blood between patients with ACS and those with stable coronary diseases using single comprehensive parameter. Materials and Methods: Consecutive patients with ACS (n = 146) and those with stable coronary heart diseases (control, n = 92) were prospectively examined. Thrombogenic potential of whole blood was evaluated by blood vulnerability index measured by Micro-Channel Array Flow Analyzer (MC-FAN). Results: Blood vulnerability index was higher in ACS than in control patients (5099 ± 2278 vs. 2071 ± 389, p b 0.0001), higher in acute MI than in unstable angina patients (5693 ± 2146 vs. 3524 ± 1841, p b 0.0001), and higher in ACS patients with initial TIMI 0/1 flow grade than in those with TIMI 2/3 flow grade (6061 ± 1936 vs. 2560 ± 1301, p b 0.0001). Furthermore, blood vulnerability index decreased from acute to chronic stage in acute MI patients. Multivariate logistic regression analysis revealed that high blood vulnerability index, high LDL cholesterol, high CRP, no use of aspirin, and no use of β-blocker were the independent contributors for the onset of ACS. Conclusion: High thrombogenic potential of whole blood evaluated by blood vulnerability index was significantly associated with ACS and was reduced from acute to chronic stage in acute MI. Condensed Abstract: Thrombogenic potential of whole blood was evaluated by blood vulnerability index measured comprehensively by Micro-Channel Array Flow Analyzer (MC-FAN) in consecutive patients with ACS (n = 146) or stable coronary diseases (control, n = 92) prospectively. Blood vulnerability index was significantly higher in ACS patients, especially in acute MI and poor initial TIMI flow grade patients, compared with control patients; and blood vulnerability index was reduced from acute to chronic stage in acute MI patients. © 2011 Elsevier Ltd. All rights reserved. Vulnerable plaques are supposed to cause acute coronary syndrome (ACS) by their disruption and subsequent thrombus formation. However, none of the diagnostic methodologies has succeeded in predicting the onset of ACS from a specific vulnerable plaque defined by each methodology, and silent plaque ruptures [1–5] have been detected widely in the coronary arteries of non-ACS patients. Thrombogenic potential of blood may be an important factor for the onset of ACS; and increased platelet reactivity or coagulation factors have been reported to be associated with ACS. However, there is no established way to evaluate thrombogenic potential of whole blood comprehensively by single parameter, although some devices such as thrombelastography and rotation thrombelastometry have been developed trying to evaluate the whole blood coagulation status under the static condition without blood flow. Therefore, in the present study, we have evaluated the thrombogenic potential of whole blood by a single parameter, i.e., blood vulnerability index, which is measured from the volume-time curve of blood flow run through the micro-channels until it stops by thrombotic occlusion, and compared it between unselected ACS and non-ACS patients to clarify the association between the parameter and ACS. Materials and methods Study patients A series of consecutive patients with ACS who received emergent catheterization (ACS group, n = 146) and consecutive patients with Thrombosis Research 128 (2011) 268–273 Abbreviations: ACS, acute coronary syndrome; IVUS, intravascular ultrasound; MI, myocardial infarction; PCI, percutaneous coronary intervention. ⁎ Corresponding author at: Cardiovascular Division, Osaka Police Hospital, 10–31 Kitayama-cho, Tennoji-ku, Osaka, 543–0035 Japan. Tel.: +81 6 6771 6051; fax: +81 6 6775 2845. E-mail address: ueda@oph.gr.jp (Y. Ueda). 0049-3848/$ – see front matter © 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.thromres.2011.04.001 Contents lists available at ScienceDirect Thrombosis Research journal homepage: www.elsevier.com/locate/thromres