{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T16:45:59Z","timestamp":1778604359677,"version":"3.51.4"},"reference-count":32,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T00:00:00Z","timestamp":1748304000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Up to 50% of patients with ST\u2010segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) develop coronary microvascular dysfunction (CMD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aims to assess whether a prothrombotic state of coronary blood, defined by thromboelastography (TEG), is associated with post\u2010pPCI CMD in STEMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      TEG analysis of infarct\u2010related coronary artery (IRA) blood was performed in 25 consecutive STEMI patients before and after successful pPCI. CMD was defined by high values of the angiography\u2010derived index of microcirculatory resistance (IMR\n                      <jats:sub>angio<\/jats:sub>\n                      \u2265\u200940 units).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The median age was 59 (IQR 51\u221271) years. CMD was observed in 13 (52%) patients. Pre\u2010pPCI Reaction (R) and Kinetic (K) time of the coronary blood from the IRA were inversely correlated with IMR\n                      <jats:sub>angio<\/jats:sub>\n                      (rho \u22120.45,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02; rho \u22120.62,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002 respectively). R time was significantly shorter in patients who developed CMD (10.7 [IQR 8.8, 13.1] vs. 18.2 [IQR 12.6, 24.2],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05), and it provided an overall good diagnostic accuracy in predicting CMD (AUC 0.75, [95% CI 0.53\u22120.96]\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.05). Similar relationship was founded for K time: 3.5 [IQR 2.2\u22124.6] versus 10.6 [IQR 4.5\u221230.0]\u2009min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01; AUC 0.82, [95% CI 0.64\u22120.99]\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01. Moreover,\n                      <jats:italic>\u03b1<\/jats:italic>\n                      angle was significantly larger (57.4 [IQR 46.5\u221264.8] vs. 40.0 [IQR 39.0\u221249.5],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03) in patients with CMD (AUC 0.78, [95% CI 0.57\u22120.98],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). Coronary post\u2010pPCI TEG parameters were not associated with CMD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this proof\u2010of\u2010concept study, a prothrombotic state of coronary blood from the IRA is associated with CMD. Further studies are warranted to evaluate if TEG may enhance individualized therapies in patients with STEMI at risk of CMD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.31612","type":"journal-article","created":{"date-parts":[[2025,5,27]],"date-time":"2025-05-27T06:00:27Z","timestamp":1748325627000},"page":"836-845","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Increased Thrombogenicity is Associated With Coronary Microvascular Dysfunction in Patients With STEMI\u2014A Proof\u2010of\u2010Concept Study"],"prefix":"10.1002","volume":"106","author":[{"given":"Roberto","family":"Scarsini","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Cardiology University of Verona Verona 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