Fractal dimension: A novel clot microstructure biomarker use in ST elevation myocardial infarction patients
| Autor: | Lindsay D’Silva, Alexander Chase, Simon J. Davidson, Roger H. K. Morris, Phillip A. Evans, Phylip Rhodri Williams, Ahmed Sabra, Phillip Thomas, David Smith, Matthew Lawrence, Karl Hawkins, Daniel R. Obaid, Martin Rowan Brown |
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| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Platelet Aggregation Point-of-care testing medicine.medical_treatment Myocardial Infarction Coronary Angiography Percutaneous Coronary Intervention Fibrinolytic Agents St elevation myocardial infarction Predictive Value of Tests Internal medicine medicine Coagulation testing Humans Myocardial infarction Prospective Studies Blood Coagulation Aged Aged 80 and over business.industry Viscosity Coronary Thrombosis Percutaneous coronary intervention Anticoagulants Reproducibility of Results Venous blood Middle Aged medicine.disease Thrombosis Elasticity Surgery Fractals Treatment Outcome Point-of-Care Testing Cardiology Microscopy Electron Scanning Biomarker (medicine) Feasibility Studies Female Blood Coagulation Tests Cardiology and Cardiovascular Medicine business Platelet Aggregation Inhibitors |
| Popis: | Objectives Changes in clot microstructure are increasingly implicated in the pathology of atherosclerosis although most data are from techniques in the remote laboratory using altered blood. We validate the novel biomarker Gel Point in STEMI patients and assess therapeutic interventions. Gel Point marks the transition of blood from a visco-elastic liquid to visco-elastic solid and is rapidly measured using unadulterated blood. The Gel Point provides measurements of three parameters to reflect clot microstructure (fractal dimension ( d f )), real-time clot formation time ( T GP ) and blood clot strength (elasticity at the Gel Point ( G ′ GP )). Methods We prospectively recruited 38 consecutive patients with STEMI undergoing primary percutaneous coronary intervention (pPCI). Venous blood samples were collected on admission, after pPCI and 24 h after admission for assessment of the new biomarkers, standard coagulation tests and scanning electron microscopy (SEM). Results d f after pPCI was lower than d f on admission (mean 1.631 [SD 0.063] vs 1.751 [0.052], p d f at 24 h was similar to that on admission. G ′ GP also showed similar trend to d f (p T GP was prolonged at after-PCI measurement compared with admission (median 854 s [IQR 581–1801] vs 217 [179–305], p d f and G ′ GP were consistent with changes in the SEM images of the mature clot. Conclusions We characterise Gel Point derived markers of clot microstructure in patients admitted with emergency arterial thrombosis. This point of care test can potentially be used to assess the efficacy of therapeutic interventions by measuring changes in clot microstructure. |
| Databáze: | OpenAIRE |
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