Significant association between neutrophil aggregation in aspirated thrombus and myocardial damage in patients with ST-segment elevation acute myocardial infarction.
BACKGROUND
This study was designed to clarify the relationship between myocardial damage and platelet-neutrophil aggregation in patients with acute myocardial infarction (AMI).


RESULTS
The study group comprised 107 patients with ST-segment elevation AMI, in whom aspiration catheter was used during emergency percutaneous coronary intervention. Patients were divided into 2 groups according to the cellular density of neutrophils in the aspirated sample: group L (n=53), <or=100 neutrophils/0.025 mm(2) thrombus; group H (n=54), >100 neutrophils/0.025 mm(2) thrombus. Myocardial blush grade (MBG) <or=1 and ST-segment resolution (STR) <50% were more frequently found in group H than in group L. Peak creatine kinase level tended to be higher and left ventricular ejection fraction (LVEF) at 6 months after onset was lower in group H than in group L. Multivariate analysis showed that high neutrophil density in aspirated thrombus was an independent predictor of MBG <or=1, STR <50%, and low LVEF at 6 months after onset.


CONCLUSIONS
Platelet-neutrophil aggregates retrieved from ruptured plaque may be associated with impaired coronary microcirculation and resultant myocardial necrosis/dysfunction. These findings underscore the clinical importance of the interaction between thrombosis and inflammation in the pathogenesis of AMI.
Arakawa
Kentaro
K
Division of Cardiology, Department of Internal Medicine, National Cardiovascular Center, Suita, Japan.
Yasuda
Satoshi
S
Hao
Hiroyuki
H
Kataoka
Yu
Y
Morii
Isao
I
Kasahara
Yoichiro
Y
Kawamura
Atsushi
A
Ishibashi-Ueda
Hatsue
H
Miyazaki
Shunichi
S
D000368:Aged; D001792:Blood Platelets / Q000473:pathology; D006328:Cardiac Catheterization; D002449:Cell Aggregation; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology; D003402:Creatine Kinase / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000473:pathology*; D009205:Myocarditis / Q000473:pathology*; D009504:Neutrophils / Q000473:pathology*; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D013927:Thrombosis / Q000473:pathology*; D020257:Ventricular Remodeling / Q000502:physiology
D003402:Creatine Kinase