Organized Thrombus in Aspirated Coronary Materials Can Predict In-Hospital Mortality of Patients With Acute Myocardial Infarction
Organized Thrombus in Aspirated Coronary Materials Can Predict In-Hospital Mortality of Patients With Acute Myocardial Infarction
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DOI：
10.1253/circj.cj-12-0911
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发表时间：
2013-05-01
影响因子：
3.3
通讯作者：
Asada, Yujiro
中科院分区：
文献类型：
--
作者：
Nishihira, Kensaku;Hatakeyama, Kinta;Asada, Yujiro
背景：血栓在破裂的动脉粥样硬化斑块上传播导致急性心肌梗死（AMI）。近年来的研究表明，冠状动脉血栓的组织病理学与AMI患者的心肌再灌注、ST段恢复、远端栓塞和长期死亡率有关。因此，我们调查了材料的组织病理学特征，在AMI患者经皮冠状动脉介入治疗（PCI）抽吸，并评估组织学结果是否与住院mortality.Methods和Results相关：在这个前瞻性单中心注册，冠状动脉材料在PCI从264 AMI患者的心绞痛症状发作的24小时内获得。对抽吸材料中的机化血栓、钙化和斑块成分进行形态学评估。17例（6%）患者发生院内死亡。264例患者中有91例（34%）发现机化血栓，44例（17%）发现钙化，117例（44%）发现斑块成分。有机化血栓患者的院内全因死亡率显著高于无机化血栓患者（P
Background: Thrombus propagation on disrupted atherosclerotic plaque leads to acute myocardial infarction (AMI). Recent studies have shown that the histopathology of the coronary thrombus is associated with myocardial reperfusion, ST-segment recovery, distal embolization and long-term mortality in patients with AMI. Therefore, we investigated the histopathologic characteristics of material aspirated during percutaneous coronary intervention (PCI) in patients with AMI, and assessed whether the histologic findings are related to in-hospital mortality.Methods and Results: In this prospective single-center registry, coronary materials were obtained during PCI from 264 AMI patients within 24h of the onset of anginal symptoms. Organized thrombus, calcification and plaque components in the aspirated material were morphologically assessed. In-hospital deaths occurred in 17 (6%) patients. Organized thrombi were found in 91(34%) of 264 patients, calcification was identified in 44 (17%) and plaque components in 117 (44%) patients. Rates of in-hospital all-cause mortality were significantly higher among patients with than without organized thrombus (P