Abstract 15609: Plasma Fibrin Clot Properties Measured Ex-vivo Are Associated With Intracoronary Thrombus Ultrastructure

Autor: Jaroslaw Zalewski, Jan Bogaert, Marcin Sadowski, Olga Woznicka, Constantinos Doulaptsis, Maria Ntoumpanaki, Michal Zabczyk, Jadwiga Nessler, Anetta Undas
Rok vydání: 2014
Předmět:
Zdroj: Circulation. 130
ISSN: 1524-4539
0009-7322
Popis: Introduction: Fibrin is a major component of intracoronary thrombus obtained during ST-elevation myocardial infarction (STEMI). Apart of the time of ischemia determinants of intracoronary thrombus composition are largely unknown. Hypothesis: We sought to investigate whether ex-vivo measured plasma fibrin clot properties are associated with intracoronary thrombus ultrastructure. Methods: In the intracoronary thrombus aspirated from 80 of the 156 consecutive STEMI patients within 12 hours since symptom onset, we assessed the content of fibrin, erythrocytes and platelets and thrombus heterogeneity by scanning electron microscopy. On admission plasma fibrin clot permeability (Ks), which indicates pore size, clot lysis time (t50%), platelet reactivity index (PRI) and aggregation induced by 5 μM of adenosine diphosphate (ADP) were correlated with intracoronary thrombus composition. Results: All patients received 300 mg of aspirin and 45 (56.3%) 600 mg of clopidogrel, 70 (41-120) min prior to aspiration. PRI inversely correlated (r=-0.24, P=0.035) with the time elapsed since clopidogrel pretreatment. The median content of fibrin, erythrocytes and platelets in intracoronary thrombus was 49.1 (25.0-72.6)%, 29.0 (4.8-57.7)% and 6.8 (1.0-15.1)%, respectively. Fibrin content was correlated with baseline Ks (r=-0.45, P Conclusion: Formation of denser fibrin clots displaying resistance to lysis, and clopidogrel pretreatment contributed to fibrin content within the intracoronary thrombus during an acute phase of STEMI.
Databáze: OpenAIRE