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Meuwissen M, Remmers MJM, Pertiwi KR, Scholzel BE, Versteylen RJ, De Boer O, Sturm MFAM, Van Den Hoef TP, Ijsselmuiden AJJ, Van Norden AGW, De Jong TEAM, Haans HAW, Aarts RAHM, Vos LD, Van Der Wal AC. P3717More fresh thrombi in cardio embolic than vascular related acute vessel syndromes. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz745.0571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Acute thrombotic occlusion may lead to major life threatening syndromes such as ST elevation myocardial infarction (STEMI) or stroke. In the majority, the underlying pathophysiology may be related to local vascular factors or thrombotic emboli. Thrombus composition might be indicative of underlying etiology and affect therapeutic considerations. Comparison of thrombi of patients suffering from both these acute syndromes has not been made yet. In this study, we compared the “age” of thrombi of patients with STEMI and acute large vessel occlusion related stroke (LVOS).
Methods and results
A total of 126 consecutive patients underwent thrombectomy for either STEMI (n=51) or LVO (n=75). All STEMI patients had vascular related occlusions. Causes of LVOS were classified according to the TOAST criteria; i.e. large artery atherosclerosis (LAA), cardio embolic (CE), other determined and embolic stroke of unknown source. Aspirated material was histopathological ordered as fresh (<1 day old), lytic (1–5 days old) or organized (>5 days old). In general, thrombi of patients with LVOS were fresher compared to thrombi of STEMI patients (p=0,04). This difference is can be attributed mainly to CE patients, which had significantly younger thrombi (p=0.001). Thrombi of LAA had comparable age with thrombi of STEMI (Figure).
Conclusion
Thrombi of cardio embolic stroke are fresher compared to that of thrombi of atherosclerotic related stroke. The latter have thrombi with comparable age of that with thrombi of ST elevation myocardial infarction. These findings may have therapeutic implications in anti-thrombotic therapies.
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Affiliation(s)
| | | | - K R Pertiwi
- Academic Medical Center, Amsterdam, Netherlands (The)
| | | | | | - O De Boer
- Academic Medical Center, Amsterdam, Netherlands (The)
| | | | | | | | | | | | | | | | - L D Vos
- Amphia Hospital, Breda, Netherlands (The)
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Blok KM, Rinkel GJE, Majoie CBLM, Hendrikse J, Braaksma M, Tijssen CC, Wong YY, Hofmeijer J, Extercatte J, Kerklaan B, Schreuder THCML, ten Holter S, Verheul F, Harlaar L, Pruissen DMO, Kwa VIH, Brouwers PJ, Remmers MJM, Schonewille WJ, Kruyt ND, Vergouwen MDI. CT within 6 hours of headache onset to rule out subarachnoid hemorrhage in nonacademic hospitals. Neurology 2015; 84:1927-32. [DOI: 10.1212/wnl.0000000000001562] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 01/27/2015] [Indexed: 11/15/2022] Open
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