Morphological and Immunohystochemical Characteristics of Aspirated Thrombi in Patients with ST-Elevation Myocardial Infarction


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Abstract

The aim of study was to evaluate the morphological and immunohystochemical characteristics of aspirated thrombi in patients with ST-elevation myocardial infarction undergoing precutaneous coronary intervention to find the possible platelet activation and inflammatory cell involvement in coronary thrombi. Materials and methods. Thrombi collected from 67 patients with ST-elevation myocardial infarction were studied. Macroscopic and immunohystochemical analyses were performed to reveal the cellular components of thrombi. The peroxidase - antiperoxidase immunohystochemical method was applied with monoclonal antibodies to CD4+, CD8+, CD15+, CD63+ and CD105+ using diaminobenzidine agent as a visualization agent to investigate the potential involvement of different cellular subpopulations. Results. The macroscopic examination revealed friable thrombi with apparent laminations (lines of Zahn). Microscopic analysis of thrombi revealed a loose meshwork of fibrin fibers with compact accumulation of activated platelets. The platelets were surrounded by neutrophilic granulocytes.The immunohystochemical analysis confirmed that cell aggregates are consisting of CD 63+ activated platelets and leucocytes. The granulocytes also tested positive for CD15 antigen. The immunohystochemical analysis revealed the presence of CD8+ cytotoxic T-lymphocytes and CD4+ helper T-lymphocytes. No expression of iNOS, CD105 and VEGF was found in the analyzed thrombi. Conclusions. The hystopathological evaluation of thrombi in patients with acute ST-elevation myocardial infarction revealed the presence of activated CD63+ platelets and CD15+ neutrophilic granulocytes. Activated platelets and neutrophils may play a role in thromboinflammatory activation course leading to destabilization of atherosclerotic plaque and development of acute thrombosis in patients with ST-elevation acute myocardial infarction.

About the authors

H S Sisakian

Yerevan State Medical University; Clinic of General and Invasive Cardiology, University Hospital №1

Email: hamayak.sisakian@doctor.com
д.м.н., проф., зав. каф. кардиологии фак-та общей медицины, рук. клиники общей и инвазивной кардиологии университетской больницы №1 Ереванского государственного медицинского университета, тел.: +374 10 58-20-23, +374 91 40-95-27 Yerevan, Armenia

A G Mkhitaryan

Yerevan State Medical University

к.м.н., доцент каф. патологической анатомии Клиники патологии Yerevan, Armenia

V G Sahakyan

Yerevan State Medical University

врач-цитолог Клиники патологии Yerevan, Armenia

A S Kocharyan

Yerevan State Medical University

научный соискатель каф. кардиологии фак-та общей медицины Yerevan, Armenia

B A Asatryan

Yerevan State Medical University

клинический ординатор каф. кардиологии фак-та общей медицины Yerevan, Armenia

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