title: Ultrastructure and composition of thrombi in coronary and peripheral artery disease: correlations with clinical and laboratory findings.
abstract: BACKGROUND
  Fibrin structure and cellular composition of thrombi profoundly affect the clinical outcomes in ischemic coronary and peripheral artery disease. Our study addressed the interrelations of structural features of thrombi and routinely measured laboratory parameters.
  
  
  METHODS
  Thrombi removed by thromboaspiration following acute myocardial infarction (n=101) or thrombendarterectomy of peripheral arteries (n=50) were processed by scanning electron microscopy and immunostaining for fibrin and platelet antigen GPIIb/IIIa to determine fibrin fibre diameter and relative occupancy by fibrin and cells. Correlations between the structural characteristics and selected clinical parameters (age, sex, vascular localization, blood cell counts, ECG findings, antiplatelet medication, accompanying diseases, smoking) were assessed.
  
  
  RESULTS
  We observed significant differences in mean fibre diameter (122 vs. 135 nm), fibrin content (70.5% vs. 83.9%), fluorescent fibrin/platelet coverage ratio (0.18 vs. 1.06) between coronary and peripheral thrombi. Coronary thrombi from smokers contained more fibrin than non-smokers (78.1% vs. 62.2% mean occupancy). In the initial 24 h, fibrin content of coronary thrombi decreased with time, whereas in peripheral thrombi platelet content increased in the first 7 days. In coronaries, higher platelet content and smaller vessel diameter were associated with thinner fibrin fibres, whereas hematocrit higher than 0.35 correlated with larger intrathrombotic platelet occupancy. Smoking and dyslipidaemia strengthened the dependence of clot platelet content on systemic platelet count (the adjusted determination coefficient increased from 0.33 to 0.43 and 0.65, respectively).
  
  
  CONCLUSIONS
  Easily accessible clinical parameters could be identified as significant determinants of ultrastructure and composition of coronary and peripheral thrombi.
authors: Department of Medical Biochemistry, Semmelweis University, Budapest, Hungary.
authors: András
authors: A
authors: Kovács
authors: Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
authors: Péter
authors: P
authors: Sótonyi
authors: Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
authors: Anikó Ilona
authors: AI
authors: Nagy
authors: Department of Information Technology, Nikola Vaptsarov Naval Academy, Varna, Bulgaria; Australian Maritime College, University of Tasmania, Launceston, Australia.
authors: Kiril
authors: K
authors: Tenekedjiev
authors: Department of Medical Biochemistry, Semmelweis University, Budapest, Hungary.
authors: Nikolett
authors: N
authors: Wohner
authors: Department of Medical Biochemistry, Semmelweis University, Budapest, Hungary.
authors: Erzsébet
authors: E
authors: Komorowicz
authors: Department of Medical Biochemistry, Semmelweis University, Budapest, Hungary.
authors: Eszter
authors: E
authors: Kovács
authors: Department of Information Technology, Nikola Vaptsarov Naval Academy, Varna, Bulgaria; Australian Maritime College, University of Tasmania, Launceston, Australia.
authors: Natalia
authors: N
authors: Nikolova
authors: Institute of Materials and Environmental Chemistry, Research Centre for Natural Sciences, Hungarian Academy of Sciences, Budapest, Hungary.
authors: László
authors: L
authors: Szabó
authors: 1(st) Department of Pathology and Experimental Cancer Research, Semmelweis University, Budapest, Hungary.
authors: Ilona
authors: I
authors: Kovalszky
authors: Department of Medical Biochemistry, Semmelweis University, Budapest, Hungary.
authors: Raymund
authors: R
authors: Machovich
authors: Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
authors: Zsolt
authors: Z
authors: Szelid
authors: Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
authors: David
authors: D
authors: Becker
authors: Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
authors: Béla
authors: B
authors: Merkely
authors: Department of Medical Biochemistry, Semmelweis University, Budapest, Hungary. Electronic address: Krasimir.Kolev@eok.sote.hu.
authors: Krasimir
authors: K
authors: Kolev
mesh_terms: D001792:Blood Platelets / Q000166:cytology / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging*; D013927:Thrombosis / Q000097:blood / Q000378:metabolism*; D014463:Ultrasonography
keywords: Fibrin; Myocardial infarction; Peripheral artery disease; Platelet; Thrombus