1. Hospital Universitario de Canarias. Servicio de Cardiología. Santa Cruz de Tenerife. Spain.
2. Facultad de Ciencias de la Salud. Universidad Europea de Canarias. La Orotava. Santa Cruz de Tenerife. Spain.
3. Departamento de Ciencias Médicas Básicas (Unidad de Fisiología), Universidad de La Laguna. Santa Cruz de Tenerife. Spain.
4. Hospital Universitario de Santa Lucía de Cartagena, Servicio de Cardiología. Murcia. Spain.
5. Hospital Universitario Central de Asturias. Área del Corazón. Oviedo. Spain.
6. Hospital Universitario de Santa Lucía de Cartagena, Servicio de Anatomía Patológica. Murcia. Spain.
Recent studies have demonstrated that inflammatory cells are a component that plays a role in thrombus formation in ST-elevation myocardial infarction (STEMI). 3-nitrotyrosine (3-NO2-Tyr), a specific marker for protein modification by nitric oxide-derived oxidants, is increased in human atherosclerotic lesions. The purpose of this study was to determine the possible association of inflammatory markers of coronary thrombi with nitroxidative stress. Intracoronary thrombus (n=51) and blood from the systemic circulation were obtained by thromboaspiration in 138 consecutive STEMI patients presenting for primary percutaneous coronary intervention (PCI). Each blood and intracoronary thrombus were measured simultaneously the following biomarkers: C-reactive protein (CRP), 3-NO2-Tyr, soluble CD 40 ligand (sCD40L), vascular cellular adhesion molecule-1 (VCAM-1) and haemoglobin content (only in coronary thrombus).
Time delay in minutes from symptom onset to PCI was 244 ± 324. Serum CRP was positively correlated to CRP content in the thrombus (r= 0.395; p = 0.02) and serum sCD40L was negatively correlated to sCD40L in the thrombus (r= -0.394; p = 0.02). Patients were divided into tertiles according to thrombi 3-NO2-Tyr concentration: 1sttertile (<0.146ng/mg), 2ndtertile (0.146-0.485ng/mg) and 3rdtertile (>0.485ng/mg). Thus, thrombus in the highest tertile had significantly higher levels of CRP (p=0.002), VCAM-1 (p=0.003) and haemoglobin (p=0.002). In conclusion, the present study demonstrated that coronary thrombi with higher levels of 3-NO2-Tyr content often contain more inflammatory markers which could have a direct impact on the efficacy of drugs or devices used for coronary reperfusion.
Keywords: coronary thrombosis, inflammation, myocardial infarction, oxidative stress, percutaneous coronary intervention.