Immunohistochemical and Molecular Characteristics of Coronary Thrombus Resistant to Fibrinolysis

Sambola, Antonia; Francisco, Jaume; Blanco, Bruno García del; Ruiz‐Meana, Marisol; Martí, Gerard; Otaegui, Imanol; Serra, Viçens; Barrabés, José A.; Figueras, Jaume; Garcı́a-Dorado, David

doi:10.1016/s0735-1097(12)60449-5

Cited by 4 publications

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“…12,21 Such studies, when performed in patients with acute coronary syndromesin vivo, are scarce in the literature. 13 In a recent study, which highlighted the potential practical applicability of a greater knowledge of thrombus structure, Sambola et al 15 assessed the thrombotic burden in aspirates from ten patients undergoing PPCI, compared to ten patients undergoing rescue PCI after ineffective response to tenecteplase. A higher concentration of neutrophils was also identified in the plaques of unstable patients.…”

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confidence: 99%

“…[12][13][14][15] In the scenario of STEMI, few studies have evaluated the immunohistochemical profile of intracoronary thrombus in vivo and its correlation with clinical variables. The expression of the endothelial cell activity, of platelet function, of and coagulation cascade activation can be estimated by the immunohistochemical expression of the antigens CD34, CD61, and factor VIII, respectively.…”

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Immunohistochemical Characteristics of Coronary Thrombi in Patients with ST-Elevation Myocardial Infarction and Diabetes Mellitus: Pilot Studyy

Ribeiro¹,

Cambruzzi²,

Sebben³

et al. 2014

Revista Brasileira de Cardiologia Invasiva (English Version)

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Background: Diabetes mellitus is associated with increased mortality rates in the setting of acute myocardial infarction. The aim of this study was to evaluate whether there are peculiarities in the atherothrombotic process that might be implicated in increased risk for this outcome in patients with diabetes. Methods: Pilot study in a cohort of patients with ST-elevation acute myocardial infarction undergoing primary percutaneous coronary intervention and aspiration thrombectomy. Clinical and laboratory variables were evaluated in all of the cases. Thrombi were analyzed for histopathological features as well as immunohistochemical expression of CD34, CD61 and factor VIII. Results: Our sample included the first ten diabetic patients with material available for analysis, who were matched according to age, gender and time elapsed since myocardial infarction with ten patients without diabetes. There was no significant association between the immunohistochemical expression of CD34, CD61 and factor VIII with other histopathological, clinical and laboratory variables, including the presence of diabetes mellitus. Conclusions: In this preliminary analysis, it was not possible to demonstrate any significant difference in the expression of endothelial cell activity, platelet function and activation of the coagulation cascade between thrombi of patients with and without diabetes undergoing primary coronary intervention. Introdução:No contexto do infarto agudo do miocárdio, o diabetes mellitus está associado à maior mortalidade. O objetivo deste estudo foi avaliar se existem, entre os diabéticos, peculiaridades no processo de aterotrombose que poderiam estar implicadas em maior risco para tal desfecho. Métodos: Estudo piloto, proveniente de coorte de pacientes com diagnóstico de infarto agudo do miocárdio com elevação do segmento ST submetidos à intervenção coronária percutânea primária e à tromboaspiração. Foram estudadas variáveis clínico-laboratoriais de cada caso. Os trombos foram analisados quanto às características histopatológicas e às expressões imuno-histoquímicas de CD34, CD61 e fator VIII. Resultados: Foram incluídos os primeiros dez pacientes portadores de diabetes mellitus com material disponível para análise, pareados por idade, sexo e tempo de evolução do infarto com dez pacientes sem diabetes mellitus. Não houve associação significativa entre as expressões imuno-histoquímicas de CD34, CD61 e fator VIII com relação às variáveis histopatológicas, laboratoriais e clínicas estudadas, inclusive com relação à presença de diabetes mellitus. Conclusões: Em análise preliminar, não foi possível demonstrar diferença significativa quanto à expressão da atividade de células endoteliais, da função plaquetária e da ativação da cascata de coagulação entre trombos de pacientes com e sem o diagnóstico de diabetes mellitus submetidos à intervenção coronariana primária. DESCRITORES:Infarto do miocárdio. Diabetes mellitus. Trombose coronária. Imuno-histoquímica. Intervenção coronária percutânea.

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