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Ultrastructure and composition of thrombi in coronary and peripheral artery disease: correlations with clinical and laboratory findings

Citation

Kovacs, A and Sotonyi, P and Ilona Nagy, A and Tenekedjiev, K and Wohner, N and Komorowicz, E and Kovacs, E and Nikolova, N and Szabo, L and Kovalszky, I and Machovich, R and Szelid, Z and Becker, D and Merkely, B and Kolev, K, Ultrastructure and composition of thrombi in coronary and peripheral artery disease: correlations with clinical and laboratory findings, Thrombosis Research, 135, (4) pp. 760-766. ISSN 0049-3848 (2015) [Refereed Article]

Copyright Statement

Copyright 2015 Elsevier Ltd.

DOI: doi:10.1016/j.thromres.2015.02.004

Abstract

Introduction: 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.

Materials and 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).

Conclusion: Easily accessible clinical parameters could be identified as significant determinants of ultrastructure and composition of coronary and peripheral thrombi.

Item Details

Item Type:Refereed Article
Keywords:myocardial infarction, peripheral artery disease, thrombus, fibrin, platelet
Research Division:Biological Sciences
Research Group:Biochemistry and Cell Biology
Research Field:Biochemistry and Cell Biology not elsewhere classified
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Blood Disorders
Author:Tenekedjiev, K (Professor Kiril Tenekedjiev)
Author:Nikolova, N (Professor Nataliya Nikolova)
ID Code:106435
Year Published:2015
Web of Science® Times Cited:4
Deposited By:NC Maritime Engineering and Hydrodynamics
Deposited On:2016-02-10
Last Modified:2016-09-21
Downloads:0

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