Bacterial signatures in thrombus aspirates of patients with myocardial infarction

Autor: Teppo Haapaniemi, Juhani Airaksinen, Jussi Mikkelsson, Matti Niemi, Pasi P. Karjalainen, V. Karhunen, Antti Ylitalo, Pekka J. Karhunen, Kari Lounatmaa, Mikko Pietilä, Tanja Pessi, Reijo Laaksonen, Terho Lehtimäki
Rok vydání: 2013
Předmět:
DNA
Bacterial
Male
Pathology
medicine.medical_specialty
medicine.medical_treatment
Lipopolysaccharide Receptors
Myocardial Infarction
Antigens
Differentiation
Myelomonocytic
030204 cardiovascular system & hematology
law.invention
03 medical and health sciences
0302 clinical medicine
law
Antigens
CD
Physiology (medical)
Oral and maxillofacial pathology
Biopsy
medicine
Humans
Myocardial infarction
Thrombus
Polymerase chain reaction
Retrospective Studies
medicine.diagnostic_test
business.industry
Macrophages
Biopsy
Needle
Stomatognathic Diseases
Percutaneous coronary intervention
Thrombosis
030206 dentistry
ta3121
Middle Aged
medicine.disease
Viridans Streptococci
3. Good health
Real-time polymerase chain reaction
Female
Cardiology and Cardiovascular Medicine
business
Mouth Diseases
Biomarkers
Zdroj: Circulation
Circulation; Vol 127
ISSN: 1524-4539
Popis: Background— Infectious agents, especially bacteria and their components originating from the oral cavity or respiratory tract, have been suggested to contribute to inflammation in the coronary plaque, leading to rupture and the subsequent development of coronary thrombus. We aimed to measure bacterial DNA in thrombus aspirates of patients with ST-segment–elevation myocardial infarction and to check for a possible association between bacteria findings and oral pathology in the same cohort. Methods and Results— Thrombus aspirates and arterial blood from patients with ST-segment–elevation myocardial infarction undergoing primary percutaneous coronary intervention (n=101; 76% male; mean age, 63.3 years) were analyzed with real-time quantitative polymerase chain reaction with specific primers and probes to detect bacterial DNA from several oral species and Chlamydia pneumoniae. The median value for the total amount of bacterial DNA in thrombi was 16 times higher than that found in their blood samples. Bacterial DNA typical for endodontic infection, mainly oral viridans streptococci, was measured in 78.2% of thrombi, and periodontal pathogens were measured in 34.7%. Bacteria-like structures were detected by transmission electron microscopy in all 9 thrombus samples analyzed; whole bacteria were detected in 3 of 9 cases. Monocyte/macrophage markers for bacteria recognition (CD14) and inflammation (CD68) were detected in thrombi (8 of 8) by immunohistochemistry. Among the subgroup of 30 patients with myocardial infarction examined by panoramic tomography, a significant association between the presence of periapical abscesses and oral viridans streptococci DNA–positive thrombi was found (odds ratio, 13.2; 95% confidence interval, 2.11–82.5; P =0.004). Conclusions— Dental infection and oral bacteria, especially viridans streptococci, may be associated with the development of acute coronary thrombosis.
Databáze: OpenAIRE
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