الفهرس 
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Abstract
Background: ST segment elevation myocardial infarction (STEMI) comprises approximately 25-40% of myocardial infarction (MI) presentation. The pathophysiology of acute coronary syndrome (ACS) is rupture or erosion of the fibrous cap overlying lipid rich plaques within the arterial tree. This event exposes pro-inflammatory substances, ultimately resulting in platelet aggregation and formation of obstructive thrombus.
Aim of the work: Identify predictors of heavy thrombus burden in patients with STEMI undergoing primary percutaneous coronary intervention (PCI) within 12 hours from onset of chest pain.
Patients and Methods: Our study included 200 consecutive patients who presented with STEMI and were managed by primary PCI within 12 hours from onset of chest pain. All patients were subjected to thorough history taking ] e.g. Age, HTN, family history of premature coronary artery disease (CAD) and pain to balloon time [, clinical examination, electrocardiogram (ECG), biochemical biomarkers, PCI and transthoracic echocardiography (TTE).
Results: Our study showed that there was significant positive correlation between grading of thrombus burden with age (rho = 0.165; P=0.020), HTN (rho = 0.143; P=0.043), number of risk factors (rho = 0.253; P < 0.001), Killip classification (rho = 0.211; P=0.003), pain to balloon time (rho = 0.453; P < 0.001), ST elevation score (rho = 0.185; P=0.009), RDW (rho = 0.878; P < 0.001), TLC (rho = 0.445; P < 0.001), troponin (rho = 0.600; P < 0.001), CK-MB (rho = 0.661; P < 0.001) and CPK(rho = 0.533; P< 0.001) and N/L ratio (rho=0.563; P=<0.001) also, there was significant negative correlation between grading of thrombus burden with EF (rho = -0.397; P < 0.001).
Conclusion: There was significant positive correlation between age, number of cardiovascular risk factor, pain to balloon time, Killip classification, RDW, TLC, N/L ratio and grading of thrombus burden. Only pain to balloon and RDW were considered as independent predictors of heavy thrombus burden