Huertas-Nieto Sergio, Moraga-Yébenes Ana, Zamora-Pérez Lydia, Moreno Guillermo, Maneiro-Melón Nicolás, Sarnago-Cebada Fernando, Kadir Berk Feyzi, Medina Aitana, García-Martín Rosa María, Lizasoain Ignacio, Bueno Héctor
Cardiology Department, University Hospital Nuestra Señora de Candelaria, Tenerife, Spain.
Instituto de Investigación Sanitaria Hospital Universitario 12 de Octubre (I+12 Institute), Madrid, Spain.
J Cardiovasc Transl Res. 2025 Sep 3. doi: 10.1007/s12265-025-10676-1.
Neutrophil extracellular traps (NETs) are implicated in thrombosis and inflammation during acute myocardial infarction (AMI), but their kinetics, local distribution, and clinical relevance remain unclear. We conducted a prospective study in 144 patients with ST-segment elevation (STEMI) and non-ST-segment elevation AMI (NSTEMI) undergoing coronary angioplasty (PCI), quantifying double-stranded DNA (dsDNA), myeloperoxidase (MPO), and neutrophil elastase (NE) in the infarct-related artery (IRA), contralateral coronary artery (CCA), and peripheral blood. Coronary thrombi and DNASE1 Q222R were also analysed. NET markers were elevated in the IRA, and NE and dsDNA increased peripherally after PCI. IRA NE levels independently predicted cardiovascular events (HR, 1.76; 95%CI: 1.24 - 2.51). Thrombi with higher NE and citrullinated histone H3 content were associated with suboptimal PCI results. dsDNA levels were significantly higher in patients with the GG DNASE1 genotype. These findings indicate a compartmentalized NET response in AMI and support a potential prognostic impact of NETs.
中性粒细胞胞外诱捕网（NETs）与急性心肌梗死（AMI）期间的血栓形成和炎症有关，但其动力学、局部分布及临床相关性仍不明确。我们对144例接受冠状动脉血管成形术（PCI）的ST段抬高型心肌梗死（STEMI）和非ST段抬高型心肌梗死（NSTEMI）患者进行了一项前瞻性研究，对梗死相关动脉（IRA）、对侧冠状动脉（CCA）和外周血中的双链DNA（dsDNA）、髓过氧化物酶（MPO）和中性粒细胞弹性蛋白酶（NE）进行定量分析。还对冠状动脉血栓和DNASE1 Q222R进行了分析。NET标志物在IRA中升高，PCI术后外周血中的NE和dsDNA增加。IRA中NE水平可独立预测心血管事件（HR，1.76；95%CI：1.24 - 2.51）。NE和瓜氨酸化组蛋白H3含量较高的血栓与PCI结果欠佳相关。GG DNASE1基因型患者的dsDNA水平显著更高。这些发现表明AMI中存在分区化的NET反应，并支持NETs具有潜在的预后影响。
