Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Fuwai Hospital, National Centre for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, China.
Thromb Res. 2021 Jul;203:5-11. doi: 10.1016/j.thromres.2021.04.015. Epub 2021 Apr 19.
To investigate the association between neutrophil extracellular traps (NETs) in coronary thrombus and risk profile of patients with ST-segment elevation myocardial infarction (STEMI).
All participants enrolled in the Optical Coherence Tomography Examination in Acute Myocardial Infarction (NCT03593928) registry from March 2017 to November 2019 were screened and 104 patients were qualified for the current analysis. Coronary aspirated materials were collected and culprit lesion characteristics were examined by optical coherence tomography. NETs in thrombus were identified by immunofluorescence as the co-localization of anti-histone H3 and myeloperoxidase, and NETs level was assessed using a semi-quantitative score. Patient-oriented composite endpoint included all-cause death, myocardial infarction, stroke, any revascularization, and re-admission for heart failure.
According to NETs burden, 44 patients were in the low NETs group and 60 in the high NETs group. The two groups were comparable in age, sex, and comorbidities but the high NETs group presented with significantly higher level of high-sensitivity C reactive protein than the low NETs group (median 9.3 mg/L vs 5.2 mg/L, p = 0.036). Although culprit plaque morphology did not differ between groups, the lipid arc was smaller (maximal lipid arc 320° vs 360°, p = 0.012) and the flow area was larger (median 1.85mm vs 1.65mm, p = 0.041) in the high NETs group. No significant difference was observed between groups in patient-oriented composite endpoint.
Increased NETs in aspirated coronary thrombus appear to be associated with more elevated inflammation but less advanced atherosclerosis.
ClinicalTrials.gov: NCT03593928.
探讨冠状动脉血栓中中性粒细胞胞外诱捕网（NETs）与 ST 段抬高型心肌梗死（STEMI）患者风险特征之间的关系。
筛选 2017 年 3 月至 2019 年 11 月期间参加光学相干断层扫描急性心肌梗死研究（NCT03593928）登记研究的所有患者，符合条件的 104 例患者纳入本分析。收集冠状动脉抽吸物，通过光学相干断层扫描检查罪犯病变特征。通过抗组蛋白 H3 和髓过氧化物酶的共定位来识别血栓中的 NETs，并使用半定量评分评估 NETs 水平。以患者为导向的复合终点包括全因死亡、心肌梗死、卒中和任何血运重建以及心力衰竭再入院。
根据 NETs 负担，44 例患者归入低 NETs 组，60 例归入高 NETs 组。两组在年龄、性别和合并症方面无差异，但高 NETs 组的高敏 C 反应蛋白水平显著高于低 NETs 组（中位数 9.3mg/L 比 5.2mg/L，p=0.036）。尽管两组罪犯斑块形态无差异，但高 NETs 组的脂质弧更小（最大脂质弧 320°比 360°，p=0.012），血流面积更大（中位数 1.85mm 比 1.65mm，p=0.041）。两组在以患者为导向的复合终点方面无显著差异。
抽吸冠状动脉血栓中增加的 NETs 似乎与更高的炎症反应有关，但与更严重的动脉粥样硬化程度无关。
ClinicalTrials.gov：NCT03593928。
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