Abstract 12667: Red or White Thrombus in Patients with ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention: Does it Matter?
Background: Aspiration thrombectomy is generally used in primary percutaneous coronary interventions (pPCI), and this method allows assessment of the retrieved thrombus. The color of the thrombus, as well as its correlation with clinical, laboratorial and angiographic findings was not yet investigated in current practice.
Methods: We studied 57 consecutive patients with ST-elevation myocardial infarction (STEMI) undergoing pPCI between April and November 2010. Clinical, angiographic and laboratory characteristics were prospectively assessed. Thrombus material was obtained and color of thrombus was classified as white or red. All samples were analyzed by 3 independent pathologists blinded to clinical characteristics and outcomes. The specimens were hold in 10% formalin, paraffin embedded, hematoxylin-eosin stained, and analyzed by optical microscopy.
Results: The mean age of the patients was 60.56 ± 11.81 years and 68% were male. White thrombus was present in 33% of the cases, and red thrombus in 67 %. Clinical, laboratorial, and histological characteristics as well as clinical outcomes according to the thrombus color are shown in the table. Total ischemic time was correlated with fibrin infiltration (R=0.35; p<0.01), and total thrombus burden (R=0.26; p=0.05).
Conclusions White thrombus was present in one third of cases, and was associated with lower ischemic times, higher fibrin infiltration, smaller thrombus volume, better TIMI flow and lower 30-day mortality when compared to red thrombus. Larger studies to validate our findings are warranted. Table. Clinical, laboratorial, histological characteristics and outcomes according to the thrombus color. DIV>
- © 2011 by American Heart Association, Inc.