期刊
THROMBOSIS RESEARCH
卷 203, 期 -, 页码 5-11出版社
PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.thromres.2021.04.015
关键词
Neutrophil extracellular trap; ST-segment elevation myocardial infarction; Optical coherence tomography; Inflammation; Thrombus
资金
- National Natural Science Foundation of China [81970308]
- Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences
- Fund of Sanming Project of Medicine in Shenzhen [SZSM201911017]
This study aimed to investigate the association between NETs in coronary thrombus and risk profile of STEMI patients, finding that patients in the high NETs group had higher levels of high-sensitivity C reactive protein and increased NETs in aspirated coronary thrombus were associated with more elevated inflammation but less advanced atherosclerosis.
Aim: To investigate the association between neutrophil extracellular traps (NETs) in coronary thrombus and risk profile of patients with ST-segment elevation myocardial infarction (STEMI). Methods: All participants enrolled in the Optical Coherence Tomography Examination in Acute Myocardial Infarction (NCT03593928) registry from March 2017 to November 2019 were screened and 104 patients were qualified for the current analysis. Coronary aspirated materials were collected and culprit lesion characteristics were examined by optical coherence tomography. NETs in thrombus were identified by immunofluorescence as the co-localization of anti-histone H3 and myeloperoxidase, and NETs level was assessed using a semiquantitative score. Patient-oriented composite endpoint included all-cause death, myocardial infarction, stroke, any revascularization, and re-admission for heart failure. Results: According to NETs burden, 44 patients were in the low NETs group and 60 in the high NETs group. The two groups were comparable in age, sex, and comorbidities but the high NETs group presented with significantly higher level of high-sensitivity C reactive protein than the low NETs group (median 9.3 mg/L vs 5.2 mg/L, p = 0.036). Although culprit plaque morphology did not differ between groups, the lipid arc was smaller (maximal lipid arc 320 degrees vs 360 degrees, p = 0.012) and the flow area was larger (median 1.85mm2 vs 1.65mm2, p = 0.041) in the high NETs group. No significant difference was observed between groups in patient-oriented composite endpoint. Conclusion: Increased NETs in aspirated coronary thrombus appear to be associated with more elevated inflammation but less advanced atherosclerosis. Trial registration number: ClinicalTrials.gov: NCT03593928
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