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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
  1. Hiroshi Iwata1,
  2. Masataka Sata1,2,
  3. Jiro Ando1,
  4. Hideo Fujita1,
  5. Toshihiro Morita1,
  6. Daigo Sawaki1,
  7. Masao Takahashi1,
  8. Yoichiro Hirata2,
  9. Shuichiro Takanashi3,
  10. Minoru Tabata3,
  11. Yasunobu Hirata1,
  12. Ryozo Nagai1
  1. 1Department of Cardiovascular Medicine, University of Tokyo, Graduate School of Medicine, Tokyo 113-8655, Japan
  2. 2Department of Cardiovascular Medicine, Institute of Health Biosciences, The University of Tokushima Graduate School of Medicine, Tokushima 770-8503, Japan
  3. 3Department of Cardiovascular Surgery, Sakakibara Heart Institute, Tokyo 183-0003, Japan
  1. Correspondence to Dr Hiroshi Iwata, Department of Cardiovascular Medicine, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan; hiroiwata-circ{at}umin.ac.jp

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.

  • Primitive stem cell
  • restenosis
  • ST-elevation myocardial infarction
  • thrombus

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Footnotes

  • Funding This study was supported in part by the Program for the Promotion of Basic and Applied Researches for Innovations in Bio-oriented Industry and by grants from the Ministry of Education, Culture, Sports, Science and Technology of Japan (Knowledge Cluster and New Research Area) and the Ministry of Health, Labor and Welfare of Japan.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the ethics committee of the University of Tokyo.

  • Provenance and peer review Not commissioned; externally peer reviewed

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