title: Coronary thrombus composition: links with inflammation, platelet and endothelial markers.
abstract: OBJECTIVE
  We investigated whether markers of platelet, neutrophil and endothelial activation, plasma fibrin clot properties and patient clinical profile may characterize coronary thrombus composition in ST-segment elevation myocardial infarction (STEMI) patients.
  
  
  METHODS
  A total of 40 intracoronary thrombi obtained 4.0-16.5 h since chest pain onset by manual aspiration during primary coronary intervention (PCI) were assessed using scanning electron microscopy. Plasma fibrin clot permeation coefficient (Ks) and clot lysis time (CLT), together with platelet and endothelial activation, fibrinolysis, and inflammation markers, were measured ex vivo in 16 patients on admission (pre-PCI group) and on the next morning in 24 patients (post-PCI group).
  
  
  RESULTS
  Fibrin, erythrocyte, platelet and white blood cell content in the thrombi were estimated at 49.1%, 24.2%, 11.6% and 3.7% respectively. In the pre-PCI group, in addition to fibrinogen, P-selectin and plasminogen activator inhibitor-1 were positively correlated with thrombus fibrin content. In the post-PCI group, in addition to von Willebrand factor antigen (vWF:Ag), soluble CD40 ligand and myeloperoxidase (MPO) were positively correlated with thrombus fibrin content. After adjustment for fibrinogen and onset-to-thrombectomy time circulating vWF:Ag in both groups, and MPO and P-selectin in the pre-PCI group were the independent predictors of fibrin-rich intracoronary thrombus presence. Other predictors were renal impairment, arterial hypertension and time from symptom onset to thrombus aspiration in all patients.
  
  
  CONCLUSIONS
  In STEMI patients coronary thrombus composition is partly characterized by plasma markers of platelet, neutrophil and endothelial activation, with a varying contribution of these factors over time.
authors.affiliation: Świętokrzyskie Cardiology Centre, Kielce, Poland. Electronic address: emsad@o2.pl.
authors.forename: Marcin
authors.initials: M
authors.lastname: Sadowski
authors.affiliation: Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland; John Paul II Hospital, Krakow, Poland.
authors.forename: Michał
authors.initials: M
authors.lastname: Ząbczyk
authors.affiliation: Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland; John Paul II Hospital, Krakow, Poland.
authors.forename: Anetta
authors.initials: A
authors.lastname: Undas
mesh_terms: D000208:Acute Disease; D000368:Aged; D001777:Blood Coagulation; D001792:Blood Platelets / Q000378:metabolism; D003331:Coronary Vessels / Q000473:pathology; D042783:Endothelial Cells / Q000166:cytology*; D004730:Endothelium, Vascular / Q000166:cytology; D005260:Female; D005337:Fibrin / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D008297:Male; D008855:Microscopy, Electron, Scanning; D008875:Middle Aged; D009504:Neutrophils / Q000378:metabolism; D019007:P-Selectin / Q000378:metabolism; D062645:Percutaneous Coronary Intervention; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D015539:Platelet Activation; D011446:Prospective Studies; D013927:Thrombosis / Q000097:blood / Q000473:pathology / Q000503:physiopathology*; D016896:Treatment Outcome
chemical_list: D019007:P-Selectin; D017395:Plasminogen Activator Inhibitor 1; C051321:SERPINE1 protein, human; D005337:Fibrin; D005340:Fibrinogen
keywords: Endothelial activation; Fibrin clot; Inflammation; Platelet; ST-Segment elevation myocardial infarction; Thrombosis; Thrombus