Key result
rt-PA achieves ~83% coronary recanalization versus control in a beagle STEMI model.
Why the study?
There is no standard large animal model for evaluating the effectiveness of potential thrombolytic therapies in STEMI.
Does rt-PA improve coronary recanalization and reduce infarct size in a novel beagle model of STEMI induced by white emboli?
Does rt-PA improve coronary recanalization and reduce infarct size in a novel beagle model of STEMI induced by white emboli?
A novel beagle model of STEMI using fibrin-rich white thrombi demonstrates high stability and successfully evaluates the efficacy of rt-PA thrombolysis.
rt-PA recanalizes white emboli in this model; hypothesis-generating and leaves open human translation.
BACKGROUND: There is still no standard large animal model for evaluating the effectiveness of potential thrombolytic therapies. Here, we aimed to develop a new beagle model with ST-elevation myocardial infarction (STEMI) by injecting autologous emboli with similar components of coronary thrombus. METHODS: 18 male beagles were included and divided into three groups: red embolus group (n = 6), white embolus group (n = 6) or white embolus + rt-PA group (n = 6). Autologous emboli were infused into the mid-distal region of the left anterior descending coronary artery. The composition of embolus was examined by scanning electron microscope (SEM). Coronary angiography was performed to verify the status of embolism. Myocardial infarct size was measured by 2, 3, 5- triphenyltetrazolium chloride (TTC) staining. RESULTS: Red thrombus was characteristic of loose reticular structure of erythrocytes under SEM, while the white embolus had compacted structure that mainly consisted of a dense mass of fibrin. Coronary angiography showed the recanalization rate was 2/6 in the red embolus group versus 0/6 in the white embolus group in three hours after occlusion. Arrhythmia, resolution of ST-segment elevation and lower T wave on the electrocardiogram appeared in the red embolus group but not in the white embolus group. Another six dogs with white thrombi were treated with rt-PA. Five out of six dogs exhibited coronary recanalization after two hours of therapy, compared to zero dogs without rt-PA treatment. The size of myocardial infarction in rt-PA group reduced significantly compared with white embolus group using TTC staining method. CONCLUSIONS: The white embolism model was more convenient experimentally and had a higher uniformity, stability and success rate. The major innovation of our study is that we applied fibrin-rich white thrombi to establish beagle model possessing features of clinically observed coronary thrombi in time window of intravenous thrombolysis of STEMI. This model can be used to evaluate new thrombolytic drugs for the treatment of STEMI.
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Zhang et al. (2016) studied ST-elevation myocardial infarction (STEMI) (n=18). rt-PA vs. White embolus without rt-PA was evaluated on Coronary recanalization rate (p=0.015). In a novel beagle model of STEMI using white emboli, treatment with rt-PA resulted in coronary recanalization in 5 of 6 dogs compared to 0 of 6 in the control group (p=0.015).
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