Intracoronary platelet- and endothelial-derived microparticles were independently related to angiographic and electrocardiographic microvascular obstruction in STEMI patients.
Observational (n=78)
Are intracoronary and systemic microparticle levels associated with microvascular obstruction in patients with STEMI undergoing primary PCI?
Intracoronary microparticles are elevated at the culprit lesion in STEMI and correlate with microvascular obstruction, suggesting a potential role in its pathogenesis.
AIMS: Microparticles (MP) are cell-derived fragments known to be increased in the blood of patients with acute coronary syndromes. We aimed to assess, in ST elevation myocardial infarction (STEMI), the systemic and local (in the culprit coronary artery) levels of platelet-derived MP (PMP, CD42+CD31+) and endothelial-derived MP (EMP, CD42-CD31+) and their relation to indexes of microvascular obstruction (MVO). METHODS AND RESULTS: In 78 STEMI patients undergoing successful primary percutaneous coronary intervention, blood samples were sequentially drawn from the aorta and the culprit coronary artery for cytofluorimetric MP detection. Thrombolysis in myocardial infarction (TIMI) flow, thrombus score (TS), corrected TIMI frame count (cTFC), myocardial blush grade (MBG), quantitative blush evaluator (QuBE) score, and 90 min ST resolution (ΣSTR) were calculated. Both PMP and EMP levels were significantly higher in the intracoronary than in the aortic blood samples. Intracoronary PMP and EMP levels were positively related to TS and cTFC and inversely related to MBG and QuBE. Aortic PMP (but not EMP) levels were related to TS and cTFC and, inversely, to QuBE. Intracoronary PMP were independently related to angiographic and electrocardiographic MVO in a multivariate model. CONCLUSION: The correlations of intracoronary EMP and of both systemic and intracoronary PMP levels with TS support the role of MP as markers of ongoing thrombosis. Moreover, the correlation of intracoronary MP with indexes of microvascular dysfunction suggests, for the first time, a possible direct role of MP in the pathogenesis of MVO.
Porto et al. (2012) conducted an observational in ST elevation myocardial infarction (n=78). Intracoronary and systemic microparticles (PMP and EMP) was evaluated on Indexes of microvascular obstruction (TIMI flow, TS, cTFC, MBG, QuBE, ΣSTR). Intracoronary platelet- and endothelial-derived microparticles were independently related to angiographic and electrocardiographic microvascular obstruction in STEMI patients.