Key result
Thrombus fibrin with atheroma is linked to ~3.5-fold higher 3-year MACE vs. fibrin alone.
Why the study?
Does the presence of atheroma in addition to fibrin in thrombectomy specimens predict worse clinical outcomes in ACS patients undergoing emergency PCI?
Cohort (n=99)
Does the presence of atheroma in addition to fibrin in thrombectomy specimens predict worse clinical outcomes in ACS patients undergoing emergency PCI?
Absolute Event Rate: 21.1% vs 5.9%
p-value: p=0.048
The presence of atheroma alongside fibrin in aspirated thrombi during emergency PCI for ACS is associated with a higher 3-year risk of MACE and target vessel revascularization.
Background Fibrin and atheroma are frequently observed in thrombectomy specimens retrieved during emergency percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS), but their clinical significance remains unclear. Purpose This study aimed to investigate the impact of fibrin and atheroma composition in thrombi on long-term clinical outcomes in ACS patients undergoing emergency PCI. Methods We analyzed 99 consecutive ACS patients who underwent aspiration thrombectomy during emergency PCI between January 2017 and December 2021. Patients were divided into two groups: fibrin-only (OF) and fibrin with atheroma (FA). Kaplan-Meier analysis was performed to evaluate the cumulative incidence of major adverse cardiovascular events (MACE), mortality, target lesion revascularization (TLR), and target vessel revascularization (TVR) over 3 years. Results The OF group comprised 56 patients, and the FA group comprised 43 patients. The cumulative incidence of MACE was significantly higher in the FA group compared to the OF group (21.1% vs. 5.9%, Log-rank p = 0.048). The mortality rate was 8.1% in the OF group, whereas no mortality was observed in the FA group. The TLR rate showed no significant difference between the two groups, whereas the TVR rate was significantly higher in the FA group compared to the OF group (18.6% vs. 4.2%, Log-rank p = 0.039). (Figure) Conclusion Classification of thrombectomy specimens based on their characteristics may provide valuable prognostic information and help predict patient outcomes following PCI for ACS.
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Nohara et al. (2025) conducted a cohort in Acute coronary syndrome (ACS) (n=99). Fibrin with atheroma in thrombi vs. Fibrin-only in thrombi was evaluated on Major adverse cardiovascular events (MACE) (p=0.048). The presence of fibrin with atheroma in thrombectomy specimens was associated with a higher 3-year incidence of MACE compared to fibrin alone (21.1% vs. 5.9%, p=0.048).
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