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Pathological Characteristics of Aspirated Thrombi From Coronary Artery Embolism in Patients With Acute Myocardial

Takao Konishi1,2, Naohiro Funayama3, Daisuke Sunaga3

  • 1Department of Cardiology, National Defense Medical College, Tokorozawa, JPN.

Cureus
|December 12, 2025
PubMed

Insights

Thrombi from acute myocardial infarction due to coronary artery embolism are richer in erythrocytes and fresher than those from atherosclerotic causes. Identifying the cause of myocardial infarction is crucial for effective anticoagulation therapy.

Area of Science:

  • Cardiology
  • Pathology
  • Biomedical Research

Background:

  • Pathological differences in thrombi between atherosclerotic causes and coronary artery embolism (CE) in acute myocardial infarction (AMI) are not well understood.
  • Understanding these differences is key for appropriate treatment strategies.

Purpose of the Study:

  • To compare the pathological features of aspirated thrombi in AMI patients with CE versus those with atherosclerotic causes (non-CE).

Main Methods:

  • Analysis of coronary thrombi from 89 AMI patients (4 CE, 85 non-CE) between 2015-2019.
  • Histopathological assessment using H&E and elastica-Masson staining.
  • Immunohistochemistry for CD34 (endothelial cells) and CD68 (macrophages).

Main Results:

  • Patients with CE had higher rates of atrial fibrillation (100% vs. 9%).
  • Thrombi in CE patients were significantly more erythrocyte-dominant (55.6% vs. 12.6%) and fresher (75% fresh vs. 18%).

Conclusions:

  • AMI due to CE involves thrombi that are more erythrocyte-dominant and fresher compared to atherosclerotic causes.
  • Distinguishing the etiology of AMI is vital for implementing targeted anticoagulation therapy for secondary prevention in CE patients.
Abstract

Keywords:
acute myocardial infarctionaspiration thrombectomycoronary artery embolismpathologypercutaneous coronary intervention

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