P3586Influence of morphological features of intracoronary thrombi on ST segment resolution in patients with STEMI after primary PCI

Background

Coronary artery thrombosis is a key element in the onset of STEMI and its further course. Coronary clots significantly vary in their morphological features and types. Perhaps, it may be caused by individual differences in thrombus formation that could have a strong influence on STEMI course and prognosis.

Purpose

To elucidate the influence of morphological features of intracoronary thrombi (IT) on ST-segment resolution (the outcome) after primary PCI in patients with STEMI.

Methods

The study included 100 patients with STEMI (female 22%, male 78%) aged 57.81±10.26 years, who underwent PCI with manual thromboaspiration within the first 12 hours (mean 7.22±3.74 h) after the onset of symptoms. The obtained ITs were examined morphologically after hematoxylin & eosin staining by the standard method and by the method proposed by prof. Zerbino that allows determining the antiquity of fibrin according to its color. Each IT was classified by five morphological features: 1) “old” or “fresh” (according to Zerbino's staining); 2) with or without layered structure; and presence or absence of 3) microchannels, 4) peripheral infiltration with neutrophil leukocytes, 5) elements of atherosclerotic plaque. Correlations between these features and incidence of ST-segment resolution in 60 minutes after primary PCI for more than 50% from baseline were analyzed.

Results

Neither IT antiquity nor presence of the atherosclerotic plaque elements had any significant correlations with ST-segment resolution. Significant positive correlation was revealed with peripheral neutrophil infiltration (r=0.42, p<0.05), and negative correlations were found with layered arrangement IT (r=−0.31, p<0.05) and presence of microchannels (r=−0.56, p<0.05). Statistically significant mathematical prognostic model of ST-segment resolution was obtained after analysis of the co-influence of all five morphological features on the outcome using logistic regression method. It included three IT features significantly correlating with ST-segment resolution:

Z = 1.13 − 0.51*V1 − 0.57*V2 − 0.94*V3

where V1 – IT with layered arrangement of fibrin, V2 – IT with microchannels' formation, V3 – IT with peripheral areas of infiltration by the neutrophil leukocytes (1 for the presence of the feature, 0 for its absence).

“Old” IT with layered structure

Conclusions

Morphological features of IT in patients with acute STEMI appear to have significant influence on the primary PCI outcomes. They may be important predictors of the disease course and treatments efficacy. Further investigations of the IT peculiarities and their influences on the course of STEMI may help to improve therapy.

Acknowledgement/Funding

Study financial support was made by authors

FAANG, establishing metadata standards, validation and best practices for the farmed and companion animal community

The Functional Annotation of ANimal Genomes (FAANG) project aims, through a coordinated international effort, to provide high quality functional annotation of animal genomes with an initial focus on farmed and companion animals. A key goal of the initiative is to ensure high quality and rich supporting metadata to describe the project's animals, specimens, cell cultures and experimental assays. By defining rich sample and experimental metadata standards and promoting best practices in data descriptions, deposition and openness, FAANG champions higher quality and reusability of published datasets. FAANG has established a Data Coordination Centre, which sits at the heart of the Metadata and Data Sharing Committee. It continues to evolve the metadata standards, support submissions and, crucially, create powerful and accessible tools to support deposition and validation of metadata. FAANG conforms to the findable, accessible, interoperable, and reusable (FAIR) data principles, with high quality, open access and functionally interlinked data. In addition to data generated by FAANG members and specific FAANG projects, existing datasets that meet the main—or more permissive legacy—standards are incorporated into a central, focused, functional data resource portal for the entire farmed and companion animal community. Through clear and effective metadata standards, validation and conversion software, combined with promotion of best practices in metadata implementation, FAANG aims to maximise effectiveness and inter‐comparability of assay data. This supports the community to create a rich genome‐to‐phenotype resource and promotes continuing improvements in animal data standards as a whole.