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Incorporation of fibrin, platelets, and red blood cells into a coronary thrombus in time and space
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SYSNO ASEP 0554916 Document Type J - Journal Article R&D Document Type Journal Article Subsidiary J Článek ve WOS Title Incorporation of fibrin, platelets, and red blood cells into a coronary thrombus in time and space Author(s) Malý, M. (CZ)
Riedel, Tomáš (UMCH-V) RID, ORCID
Štikarová, J. (CZ)
Suttnar, J. (CZ)
Kotlín, R. (CZ)
Hajsl, M. (CZ)
Toušek, P. (CZ)
Kaufmanová, J. (CZ)
Kucerka, O. (CZ)
Weisel, J. W. (US)
Dyr, J. E. (CZ)Source Title Thrombosis and Haemostasis. - : Georg Thieme Verlag - ISSN 0340-6245
Roč. 122, č. 3 (2022), s. 434-444Number of pages 11 s. Language eng - English Country DE - Germany Keywords coronary ; aspiration thrombectomy ; scanning electron microscopy Subject RIV FD - Oncology ; Hematology OECD category Hematology R&D Projects GBP205/12/G118 GA ČR - Czech Science Foundation (CSF) GA19-02739S GA ČR - Czech Science Foundation (CSF) Method of publishing Limited access Institutional support UMCH-V - RVO:61389013 UT WOS 000718575700002 EID SCOPUS 85119970139 DOI 10.1055/s-0041-1739193 Annotation We describe the internal structure, spatial organization and dynamic formation of coronary artery thrombi from ST-segment elevation myocardial infarction patients. Scanning electron microscopy (SEM) revealed significant differences among four groups of patients (<2 hours, 2–6 hours, 6–12 hours, and >12 hours) related to the time of ischemia. Coronary artery thrombi from patients presenting less than 2 hours after the infarction were almost entirely composed of platelets, with small amounts of fibrin and red blood cells. In contrast, thrombi from late presenters (>12 hours) consisted of mainly platelets at the distal end, where clotting was initiated, with almost no platelets at the proximal end, while the red blood cell content went from low at the initiating end to more than 90% at the proximal end. Furthermore, fibrin was present mainly on the outside of the thrombi and older thrombi contained thicker fibers. The red blood cells in late thrombi were compressed to a close-packed, tessellated array of polyhedral structures, called polyhedrocytes. Moreover, there was redistribution from the originally homogeneous composition to fibrin and platelets to the outside, with polyhedrocytes on the interior. The presence of polyhedrocytes and the redistribution of components are signs of in vivo clot contraction (or retraction). These results suggest why later thrombi are resistant to fibrinolytic agents and other treatment modalities, since the close-packed polyhedrocytes form a nearly impermeable seal. Furthermore, it is of particular clinical significance that these findings suggest specific disparate therapies that will be most effective at different stages of thrombus development. Workplace Institute of Macromolecular Chemistry Contact Eva Čechová, cechova@imc.cas.cz ; Tel.: 296 809 358 Year of Publishing 2023 Electronic address https://www.thieme-connect.de/products/ejournals/abstract/10.1055/s-0041-1739193
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