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World J Cardiol. Jun 26, 2016; 8(6): 362-367
Published online Jun 26, 2016. doi: 10.4330/wjc.v8.i6.362
Thrombosis in ST-elevation myocardial infarction: Insights from thrombi retrieved by aspiration thrombectomy
Daniel Rios P Ribeiro, Eduardo Cambruzzi, Marcia Moura Schmidt, Alexandre S Quadros
Daniel Rios P Ribeiro, Eduardo Cambruzzi, Marcia Moura Schmidt, Alexandre S Quadros, Instituto de Cardiologia/Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre 90620-001, Brazil
Author contributions: All of the authors contributed to this paper.
Conflict-of-interest statement: There are no conflicts of interests to disclose.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Alexandre S Quadros, MD, PhD, Instituto de Cardiologia/Fundação Universitária de Cardiologia (IC/FUC), Av. Princesa Isabel, 395, Santana, Porto Alegre 90620-001, Brazil. quadros.pesquisa@gmail.com
Telephone: +55-51-32303600 Fax: +55-51-32172035
Received: June 28, 2015
Peer-review started: July 5, 2015
First decision: August 16, 2015
Revised: March 15, 2016
Accepted: April 7, 2016
Article in press: April 11, 2016
Published online: June 26, 2016
Processing time: 360 Days and 20.3 Hours
Abstract

In patients with ST-elevation myocardial infarction, recurrent cardiovascular events still remain the main cause of morbidity and mortality, despite significant improvements in antithrombotic therapy. We sought to review data regarding coronary thrombus analysis provided by studies using manual aspiration thrombectomy (AT), and to discuss how insights from this line of investigation could further improve management of acute coronary disease. Several studies investigated the fresh specimens retrieved by AT using techniques such as traditional morphological evaluation, optical microscopy, scanning electron microscopy, magnetic resonance imaging, and immunohistochemistry. These approaches have provided a better understanding of the composition and dynamics of the human coronary thrombosis process, as well as its relationship with some clinical outcomes. Recent data signaling to new antithrombotic therapeutic targets are still emerging.

Keywords: Myocardial infarct, Aspiration, Mechanical, Thrombectomy, Thrombus, Immunohistocytochemistry

Core tip: This paper describes the importance of coronary thrombosis as a direct effector of ST-elevation acute myocardial infarction, reviewing important data provided by coronary aspiration thrombectomy regarding thrombus composition and its relationship with clinical variables. The knowledge of such data is an important basis for improving antithrombotic therapy, as it signals for potential new therapeutic targets.