Impact of primitive cells in intracoronary thrombi on lesion prognosis: temporal analysis of cellular constituents of thrombotic material obtained from patients with acute coronary syndrome. Issue 10 (6th May 2010)

• Record Type: Journal Article
• Authors: Iwata, Hiroshi; Sata, Masataka; Ando, Jiro; Fujita, Hideo; Morita, Toshihiro; Sawaki, Daigo; Takahashi, Masao; Hirata, Yoichiro; Takanashi, Shuichiro; Tabata, Minoru; Hirata, Yasunobu; Nagai, Ryozo
• Is Part Of: Heart. Volume 96:Issue 10(2010)
• Page Start: 748
• Page End: 755
• Publication Date: 2010-05-06
• Subjects: Primitive stem cell -- restenosis -- ST-elevation myocardial infarction -- thrombus; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/hrt.2009.181040
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Background: Clinical evidence suggests that intracoronary thrombus formation is associated with a high incidence of late restenosis after successful coronary intervention in patients with myocardial infarction (MI). However, little is known about the mechanism by which intracoronary thrombi play pathological roles. Methods and Results: We analysed the cellular constituents of 108 thrombi aspirated from coronary lesions with a thrombectomy device in 62 patients who underwent emergent coronary intervention for the treatment of acute (<24 h) or recent (24–72 h) ST-segment elevation MI (44 men, 18 women, aged 68.0±19.3 years). Immunohistological analysis of aspirated thrombotic materials revealed that the content of platelets, as determined by immunostaining for CD42a, had a negative correlation with the time after the onset of chest pain (correlation coefficient −0.683, p<0.01). Immunofluorescent staining for CD34 and breast cancer-resistant protein-1 (bcrp-1) detected primitive cells in intracoronary thrombi. Furthermore, the ratio of CD34-positive cells in intracoronary thrombi had a significant positive correlation with restenosis at follow-up coronary angiography (correlation coefficient 0.76, p=0.01). Conclusions: The findings of this study indicate that the early accumulation of primitive cells in platelet aggregates may play a role in neointimal growth after successful coronary intervention in patients with acute coronary syndrome.