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Dynamics of intracoronary thrombosis in STEMI and sudden death patients Kramer, M.C.A.
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Citation for published version (APA): Kramer, M. C. A. (2012). Dynamics of intracoronary thrombosis in STEMI and sudden death patients
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Download date: 20 Apr 2018
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A pattern of disperse plaque microcalcifications identifies a subset of plaques with high inflammatory burden in patients with acute myocardial infarction Xiaofei Li, Miranda C. Kramer, Chris M. van der Loos, Karel T. Koch, Onno J. de Boer, José P. Henirques, Jan Baan Jr., Marije M. Vis, Jan J. Piek, Jan G. Tijssen, Robbert J. de Winter, Allard C. van der Wal
Atherosclerosis 2011 Sep; 218(1): 83-89.
Abstract Aims: Inflammation plays a crucial role in plaque vulnerability. Calcifications can be detected by means of in vivo imaging techniques. The study purpose is to assess a potential association between tissue localization of calcifications and the inflammatory biomarkers, C-reactive protein (CRP), osteopontin and lipoprotein-associated phospholipase A2 (Lp-PLA2), in plaque tissue of patients with acute myocardial infarction (AMI). Methods and results: Thrombectomy materials obtained from patients with electrocardiographically documented ST-segment elevation type of AMI (STEMI) were histologically screened for presence of thrombus, plaque tissues and calcifications. Size of calcifications was measured morphometrically, and their colocalization with the inflammatory biomarkers macrophages, CRP, osteopontin and Lp-PLA2 was assessed with immunostaining. A total of 171 samples containing plaque tissues were obtained from 562 thrombectomy procedures. Calcifications were observed in 67 (39%) plaque fragments, with diameters ranging from 4 to 170 µm. Plaque tissues with calcifications contained more frequently extracellular CRP and intracellular CRP in macrophages than those without calcifications (85%, 59% versus 64%, 32%, p=0.012 and 0.005 respectively). Similar results were obtained with osteopontin immunostaining (98%, 76% versus 56%, 40%; p