Increased intracoronary thrombus burden in acute coronary syndrome is associated with no-reflow and distal embolization, and increased intracoronary thrombus burden causes deterioration in the left ventricle, which functions as a perfusion disorder at the microvascular level despite successful pPCI performed in STEMI patients.[14] Indeed, similar to these findings, LVEF was found to be lower in HTB patients in our study, and cTnT level, which is an indicator of myocardial injury area, was found to be higher in patients with HTB. This evidence concerns the gene TNNT2 and acute coronary syndrome.