Association of Neutrophil Extracellular Traps burden with clinical and angiographic characteristics in patients with ST-elevation myocardial infarction.
Journal
Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese
ISSN: 2241-5955
Titre abrégé: Hellenic J Cardiol
Pays: Netherlands
ID NLM: 101257381
Informations de publication
Date de publication:
06 Sep 2024
06 Sep 2024
Historique:
received:
14
06
2024
revised:
23
08
2024
accepted:
02
09
2024
medline:
9
9
2024
pubmed:
9
9
2024
entrez:
8
9
2024
Statut:
aheadofprint
Résumé
The precise triggers for atherosclerotic plaque rupture and the underlying pathophysiology of coronary thrombogenesis remain elusive. Polymorphonuclear neutrophils, particularly their formation of Neutrophil Extracellular Traps (NETs), have garnered attention in the context of coronary atherothrombosis. This study sought to explore the association of NETs burden with clinical and angiographic characteristics in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI) and thrombus aspiration (TA). For this study 336 consecutive STEMI patients undergoing pPCI were considered for TA. Aspirated thrombi underwent histological analysis and NETs quantification via immunohistochemistry. Potential associations of clinical variables and angiographic outcomes with NETs burden were assessed. Manual TA was selectively performed in 72 cases with increased thrombotic burden and 60 thrombi were suitable for analysis and included in the current study. Most thrombi specimens displayed lytic features (63%) and almost three out of four were identified as white thrombi. Increased NETs burden was significantly associated with prolonged pain-to-balloon time (>300 minutes), OR=10.29 (95% CI 2.11-42.22, p=0.001) and stress-induced hyperglycemia OR=6.58 (95% CI 1.23-52.63, p<0.01) after multivariate regression analysis. Additionally, distal embolization, a predictor of adverse outcomes, was more frequent among patients with an elevated NETs burden OR=16.9 (95% CI 4.23-44.52, p<0.01). Elevated NETs burden in STEMI thrombi may be due to delayed reperfusion, stress-induced hyperglycemia and it is associated with increased risk of distal embolization. Further research is needed to elucidate the role of NETs as a potential therapeutic target in acute atherothrombosis.
Sections du résumé
BACKGROUND
BACKGROUND
The precise triggers for atherosclerotic plaque rupture and the underlying pathophysiology of coronary thrombogenesis remain elusive. Polymorphonuclear neutrophils, particularly their formation of Neutrophil Extracellular Traps (NETs), have garnered attention in the context of coronary atherothrombosis. This study sought to explore the association of NETs burden with clinical and angiographic characteristics in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI) and thrombus aspiration (TA).
METHODS
METHODS
For this study 336 consecutive STEMI patients undergoing pPCI were considered for TA. Aspirated thrombi underwent histological analysis and NETs quantification via immunohistochemistry. Potential associations of clinical variables and angiographic outcomes with NETs burden were assessed.
RESULTS
RESULTS
Manual TA was selectively performed in 72 cases with increased thrombotic burden and 60 thrombi were suitable for analysis and included in the current study. Most thrombi specimens displayed lytic features (63%) and almost three out of four were identified as white thrombi. Increased NETs burden was significantly associated with prolonged pain-to-balloon time (>300 minutes), OR=10.29 (95% CI 2.11-42.22, p=0.001) and stress-induced hyperglycemia OR=6.58 (95% CI 1.23-52.63, p<0.01) after multivariate regression analysis. Additionally, distal embolization, a predictor of adverse outcomes, was more frequent among patients with an elevated NETs burden OR=16.9 (95% CI 4.23-44.52, p<0.01).
CONCLUSION
CONCLUSIONS
Elevated NETs burden in STEMI thrombi may be due to delayed reperfusion, stress-induced hyperglycemia and it is associated with increased risk of distal embolization. Further research is needed to elucidate the role of NETs as a potential therapeutic target in acute atherothrombosis.
Identifiants
pubmed: 39245435
pii: S1109-9666(24)00180-5
doi: 10.1016/j.hjc.2024.09.001
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2024 Hellenic Society of Cardiology. Published by Elsevier Inc. All rights reserved.