Differential features in composition of coronary thrombus of women with ST-segment elevation myocardial infarction. Issue 186 (February 2020)

• Record Type: Journal Article
• Authors: Rello, Pau; García Del Blanco, Bruno; Ruiz-Meana, Marisol; Miró-Casas, Elisabet; Alfonso, Fernando; García-Picart, Joan; Barrabés, José A.; Borrás, Guillermo; Martín, Pilar; Dorado, David García; Sambola, Antonia
• Is Part Of: Thrombosis research. Issue 186(2020)
• Page Start: 64
• Page End: 70
• Publication Date: 2020-02
• Subjects: Thrombus -- ST-elevation myocardial infarction -- Women; Thrombosis -- Periodicals; 616.135
• DOI: 10.1016/j.thromres.2019.12.010
• Languages: English
• ISSNs: 0049-3848

Abstract

Abstract: Objectives: To characterize sex differences in the composition of coronary thrombus in patients with ST-segment elevation myocardial infarction (STEMI), especially in the young (age ≤ 55 years). Background: Women have smaller coronary vessels than men and their vascular lesions can be influenced by different exposure to circulating estrogens throughout life. These factors could determine a different composition of the coronary thrombus in women with STEMI. Methods: A prospective, multicenter study was conducted on patients with STEMI and coronary thrombus was aspirated immediately before percutaneous coronary intervention (PCI) using a suction catheter (ProntoV3® or Export®). Histopathology, immunohistochemistry and ELISA techniques were used for the quantitative determination of fibrin, p-selectin and von Willebrand factor (vWF) within thrombi. Results: Thrombi were collected from 100 patients (50 men and 50 women; 13 women and 13 men of <55 years). Women presented similar baseline characteristics and pain-to-balloon elapsed time than men. Thrombi from women showed a trend to a lower concentration of fibrin than those from men [median = 1.2 ng/mg (IQR 3.5) vs median = 2.2 ng/mg (IQR 5.9), p = 0.102]. No differences were found between sexes in p-selectin and vWF concentration in thrombi. However, thrombi from young women showed lower levels of p-selectin [median = 2.2 ng/mg (IQR 4.5) vs 6.5 ng/mg (IQR 4.8), p = 0.004], fibrin [median = 1.1 ng/mg; (IQR: 3.4) vs 4.1 ng/mg (IQR 15.6), p = 0.014] and vWF [median = 3.2 ng/mg (IQR 10.6) vs 25.8 ng/mg (IQR 15.0), p = 0.003] than those from young men. Conclusions: Thrombi from young women with STEMI showed a lower content of fibrin, p-selectin and vWF than those from men. Highlights: Among patients with STEMI, young women (≤55 years old) have a lower thrombogenic content within the thrombi than young men. However, there were no differences between sexes in patients >55 years old regarding to content of thrombogenic content. Differences regarding to content within the coronary thrombi contribute to explain potential different biological mechanisms between sexes in acute coronary syndromes.