期刊
EUROPEAN HEART JOURNAL
卷 36, 期 16, 页码 965-U14出版社
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehu356
关键词
PCI; Occlusive thrombus ageing; Platelets; Profilin-1
资金
- Ministry of Economy and Competitiveness [SAF2013-42962-R]
- Institute of Health Carlos III-ISCIII [FIS PI13-2850]
- Red de Terapia Celular [TERCEL RD12/0019/0026]
- 'Red de Investigacion Cardiovascular' (RIC) [RD12/0042/0027]
- Spanish Foundation of Thrombosis and Haemostasis
- Fundacion Investigacion Cardiovascular-'Fundacion Jesus Serra'
- ICCC [2008-13]
Aim Thrombus formation is a dynamic process regulated by flow, blood cells, and plasma proteins. The present study was performed to investigate the characteristics of human coronary thrombus in ST-segment elevation myocardial infarction (STEMI). Methods and results Patients admitted with ST-elevation myocardial infarction, in which thrombectomy was performed, were included (n = 86). Intracoronary thrombi and blood from the culprit coronary site and the systemic circulation were obtained during percutaneous coronary intervention (PCI). Thrombi were categorized by onset-of-pain-to-PCI elapsed time in thrombus of <3 (T3) and more than 6 h of evolution (T6). Clinical, morphological, and proteomic variables were investigated. While T3 were mainly composed by platelets and fibrin(ogen), T6 were characterized by a reduced platelet content, increased leucocytes infiltration (including monocytes, neutrophils, T-cells, and B-cells), and appearance of undifferentiated progenitor cells. Significant differences between T3 and T6 were found in the cell cytoskeleton-associated proteome (beta-actin and tropomyosin 3 and 4). By discovery proteomics, we have identified profilin-1 (Pfn-1) in the coronary thrombi and detected higher levels in T3 than in T6. While plasma Pfn-1 levels were low in T3 patients, levels significantly increased in both coronary and peripheral circulation in T6 patients indicating release. In vitro platelet aggregation studies showed that platelets secrete Pfn-1 upon complete activation. Conclusion Coronary thrombi show rapid dynamic changes both in structure and cell composition as a function of elapsed onset-of-pain-to-PCI time. Aged ischaemic thrombi were more likely to have reduced Pfn-1 content releasing Pfn-1 to the circulation. Onset-of-pain-to-PCI elapsed time in STEMI patients and hence age of occlusive thrombus can be profiled by Pfn-1 levels found in the peripheral circulation.
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