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Updated: Dec 26, 2025
Primary Outcome Assessment in a Pig Model of Acute Myocardial Infarction
Published on: October 14, 2016
Relationship between histopathological features of aspirated thrombi and long-term left ventricular function in
Mehmet Onur Omaygenç1, Cem Doğan2, Adnan Somay3
1Department of Cardiology, İstanbul Medipol University, International Medical Faculty, İstanbul, Turkey.
Insights
Higher inflammation severity in myocardial infarction aspirates and fresh thrombi predict long-term left ventricular dysfunction. Inflammatory markers like hsCRP may reflect local inflammation intensity.
Area of Science:
- Cardiology
- Inflammation Research
Background:
- ST-elevation myocardial infarction (STEMI) can lead to impaired left ventricular (LV) function.
- Assessing inflammation severity (SOI) and thrombus characteristics may offer insights into post-STEMI LV remodeling and function.
Purpose of the Study:
- To investigate the association between inflammation severity in aspirated material and thrombus age with pre-discharge and long-term LV function after STEMI.
Main Methods:
- Aspirated thrombi from 25 STEMI patients were analyzed for leukocyte count to determine SOI (mild vs. significant).
- Thrombi were classified as fresh or lytic/organized (L/O).
- LV function and remodeling were assessed via echocardiography before discharge and at 1 year.
Main Results:
- Patients with left ventricular remodeling (LVR) had significantly higher leukocyte counts and frequency of significant inflammation.
- Serum high-sensitivity C-reactive protein (hsCRP) levels correlated significantly with aspirate leukocyte counts.
- L/O thrombi were associated with better LV volumes and ejection fraction compared to fresh thrombi.
Conclusions:
- Elevated leukocyte counts in aspirates and fresh thrombi may predict long-term LV functional deterioration post-STEMI.
- Serum inflammatory markers like hsCRP could indicate the intensity of local inflammation at the coronary occlusion site.
Objective:
This study was an investigation of the severity of inflammation (SOI) in aspirated material and thrombus age to examine any association with pre-discharge and long-term left ventricular (LV) function after ST-elevation myocardial infarction (STEMI).
Methods:
The study group comprised 25 patients with STEMI from whom an occlusive thrombus was aspirated from the infarct-related artery with a 7-F catheter. The SOI in the aspirate was determined according to the mean leukocyte count in 5 high-power magnification fields and graded as mild in the presence of ≤100 leukocytes per field or significant if there were >100 leukocytes per field. The thrombi were categorized as fresh or lytic/organized (L/O) using predefined criteria. Echocardiographic assessment was performed prior to discharge and at 1 year. Adverse left ventricular remodeling (LVR) was defined as a 20% increase in LV end-diastolic volume in comparison with baseline values.
Results:
LVR was observed in 8 patients. The mean leukocyte count of the aspirate (127.5±86.0 vs 227.2±120.7; p=0.026) and frequency of significant inflammation (35% vs 75% p=0.046) were significantly higher in the group with LVR. The serum high-sensitivity C-reactive protein (hsCRP) level was significantly correlated with the leukocyte count of the aspirate (r=0.532; p=0.006). An L/O thrombus was related to better pre-discharge and long-term LV volumes and ejection fraction values compared with a fresh thrombus.
Conclusion:
A significant increase in the leukocyte count in the aspirate and a fresh thrombus might predict long-term LV functional deterioration irrespective of the clinical and procedure-related characteristics. In addition, serum markers of inflammation, like hsCRP, might also reflect the intensity of the local inflammatory response at the site of occlusion.
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