Characterization of the relative thrombogenicity of atherosclerotic plaque components: Implications for consequences of plaque rupture
Key result
Atheromatous plaque core drives up to ~6-fold greater thrombus formation than other plaque substrates.
- P=0.0001
Why the study?
The relative thrombogenicity of different components of human atherosclerotic plaques exposed to flowing blood is not well established.
Does the atheromatous core of human atherosclerotic plaques cause greater thrombus formation compared to other plaque components when exposed to flowing blood?
Population
Human atherosclerotic plaque components and normal intima from human aortas at necropsy
Comparison
Atheromatous core with abundant cholesterol crystals versus foam cell-rich, collagen-rich, collagen-poor matrices and normal intima
Design
Ex vivo extracorporeal perfusion and in vitro perfusion systems under high shear conditions
Follow-up
5 minutes
Authors
Discussion
Loading...
Member takes
Implication
The atheromatous core is the most thrombogenic component of human atherosclerotic plaques, suggesting that plaques with a large atheromatous core pose a high risk for acute coronary syndromes upon rupture.
Key Points
- To determine whether distinct components of human atherosclerotic plaques trigger different degrees of thrombus formation when exposed to flowing blood.
- Mounted necropsy-derived human aortic substrates—foam cell-rich matrix, collagen-rich matrix, collagen-poor matrix, atheromatous core, and normal intima—into tubular perfusion chambers under high shear rate conditions (1,690 s⁻¹).
- Perfused substrates for 5 minutes with heparinized porcine blood ex vivo and heparinized human blood (2 IU/ml) in vitro.
- Quantitated thrombus formation using morphometric analysis and indium-labeled platelets, adjusting for surface irregularities with a roughness index.
- Thrombus formation on the atheromatous core was up to sixfold greater than on all other substrates, including collagen-rich matrix (p = 0.0001), in both porcine ex vivo and human in vitro perfusion systems.
- After normalizing for surface irregularities via the roughness index, the atheromatous core remained the significantly most thrombogenic substrate (p = 0.002).
Structured PICO
Does the atheromatous core of human atherosclerotic plaques cause greater thrombus formation compared to other plaque components when exposed to flowing blood?
P
Population
Ex vivo and in vitro study evaluating thrombus formation on various components of human atherosclerotic plaques exposed to flowing blood for 5 minutes.
E
Exposure
Atheromatous core with abundant cholesterol crystals
C
Comparator
Foam cell-rich matrix, collagen-rich matrix, collagen-poor matrix without cholesterol crystals, and normal intima
O
Outcome
Thrombus formation quantitated by measurement of indium-labeled platelets and morphometric analysis after 5 minutes of exposure to flowing blood under high shear rate conditions (1,690 s-1)surrogate
Main Result
p-value: p=0.0001
The atheromatous core is the most thrombogenic component of human atherosclerotic plaques, suggesting that plaques with a large atheromatous core pose a high risk for acute coronary syndromes upon rupture.
Cite This Study
Fernández‐Ortíz et al. (1994) studied Atherosclerotic plaques. Atheromatous core vs. Other plaque components (e.g., collagen-rich matrix, foam cell-rich matrix, normal intima) was evaluated on Thrombus formation (p=0.0001). The atheromatous core was the most thrombogenic component of human atherosclerotic plaques, with thrombus formation up to sixfold greater than on other substrates (p=0.0001).