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. 2005 Apr;91(4):526-30.
doi: 10.1136/hrt.2004.034058.

Proportion of fibrin and platelets differs in thrombi on ruptured and eroded coronary atherosclerotic plaques in humans

Y Sato  1 , K Hatakeyama, A Yamashita, K Marutsuka, A Sumiyoshi, Y Asada
Affiliations

Proportion of fibrin and platelets differs in thrombi on ruptured and eroded coronary atherosclerotic plaques in humans

Y Sato et al. Heart. 2005 Apr.

Abstract

Objective: To determine the proportion of platelets and fibrin in coronary thrombi.

Design: Immunohistochemical and morphometric means to examine the coronary arteries of 31 patients who died of acute myocardial infarction.

Results: Fresh thrombi were detected in the feeding arteries of infarction areas in 23 cases (74%) and were associated with plaque rupture in 18 (78%) and plaque erosion in 5 (22%). An immunohistochemical study showed that the thrombi consisted of a mixture of fibrin and platelets as well as some other types of blood cells. The fibrin and platelet positive areas in the thrombi associated with plaque rupture accounted for 74 (19)% and 35 (20)% (p < 0.01) and those associated with erosion accounted for 51 (6)% and 70 (21)%, respectively, of the total areas. Areas of positive immunoreactivity for tissue factor and C reactive protein were also significantly greater in ruptured than in eroded plaques.

Conclusion: These results indicate that the proportions of fibrin and of platelets differ in coronary thrombi on ruptured and eroded plaques. Higher proportions of tissue factor and C reactive protein contribute more significantly to thrombus formation on plaque rupture than on plaque erosion.

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Figures

Figure 1
Figure 1
Representative micrographs of plaque rupture with thrombus. (A) Thrombus on ruptured plaque (haematoxylin and eosin stain). Extensive necrotic core contains foamy macrophages and disrupted fibrous cap. Thrombus is composed of large amount of (B) fibrin and (C) platelets.
Figure 2
Figure 2
Representative micrographs of plaque erosion with thrombus. (A) Non-occlusive thrombus on eroded plaque (haematoxylin and eosin stain). Plaque is fibrous and without visible atheromatous component. Thrombus is composed of (B) fibrin and (C) platelet mixtures and is relatively more rich in platelets than in fibrin.
Figure 3
Figure 3
Representative immunohistochemical micrographs of (A, B) ruptured and (C, D) eroded plaques. Ruptured plaque is intensely immunoreactive for (A) tissue factor and (B) C reactive protein. Eroded fibrous plaque is weakly stained for (C) tissue factor and (D) C reactive protein.
See this image and copyright information in PMC

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