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. 2018 Jul 3;7(7):83.
doi: 10.3390/antiox7070083.

Interplay between Oxidative Stress and Platelet Activation in Coronary Thrombus of STEMI Patients

Camilla Calvieri  1 , Gaetano Tanzilli  2 , Simona Bartimoccia  3 , Roberto Cangemi  4 , Alessio Arrivi  5 , Marcello Dominici  6 , Vittoria Cammisotto  7 , Nicola Viceconte  8 , Enrico Mangieri  9 , Giacomo Frati  10   11 , Francesco Violi  12
Affiliations

Interplay between Oxidative Stress and Platelet Activation in Coronary Thrombus of STEMI Patients

Camilla Calvieri et al. Antioxidants (Basel). .

Abstract

Background: Platelet activation and oxidative stress seem to play a key role in coronary thrombus formation and are associated with thrombus burden in ST-elevation myocardial infarction (STEMI). However, the interplay between oxidative stress and platelet activation has not been fully elucidated.

Materials and methods: For 32 patients with STEMI undergoing primary percutaneous coronary intervention (PPCI) and 10 patients with stable angina (SA) and oxidative stress, as assessed by NADPH isoform 2 activity (soluble Nox2-derived peptide, sNox2-dp), levels of oxidized low-density lipoproteins (oxLDLs) and platelet activation markers such as soluble CD40 Ligand (sCD40L) and soluble P-selectin (sP-selectin) were measured in the retrieved material (coronary thrombi plus blood waste) of STEMI patients and in intracoronary blood of SA patients, respectively, and in peripheral blood samples of both groups.

Results: In aspirated thrombi and blood waste of STEMI patients we found higher serum levels of sNox2-dp, oxLDLs, sCD40L, and sP-selectin, as compared to the intracoronary blood samples of SA patients. Moreover, in thrombi and blood waste of STEMI patients, a direct correlation between markers of oxidative stress and of platelet activation was found. Also, in STEMI patients a progressive increase of oxidative stress and platelet activation markers was observed according to the thrombus score burden. STEMI patients showed higher peripheral blood Nox2 activity and oxLDL levels as compared to SA patients.

Conclusion: This study shows a close relationship between oxidative stress and platelet activation in the intracoronary blood waste and aspirated thrombi of STEMI patients, suggesting a role of oxidative stress in promoting thrombus formation and growth.

Keywords: STEMI; Thrombolysis in Myocardial Infarction (TIMI) thrombus score; coronary thrombus; oxidative stress; platelet activation.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Comparison of intra-coronary levels of sNox2-dp (A), oxLDLs (B), sCD40L (C), and sP-selectin levels (D) between patients with stable angina (SA) and with ST-elevation myocardial infarction (STEMI). An unpaired Student t test was used for comparison between the two groups. SA: stable angina.
Figure 2
Figure 2
Intra-thrombus levels of sNox2-dp (A), oxLDLs (B), sCD40L (C), and sP-selectin levels (D) according to thrombus burden (TIMI thrombus grade) in patients with STEMI. A one-way ANOVA with a post hoc Bonferroni test was used as appropriate to assess the distribution of oxidative stress and platelet activation markers among the study groups. TIMI: Thrombolysis in Myocardial Infarction.
Figure 3
Figure 3
Correlations between intra-thrombus oxidative stress and platelet activation markers. Correlation bivariate analysis was performed with Spearman test. The three lines indicate median values and 95% confidence intervals.
Figure 4
Figure 4
Comparison of pre-PCI peripheral levels of sNox2-dp (A), oxLDLs (B), sCD40L (C), and sP-selectin (D) between STEMI and SA patients. An unpaired Student t test was used for comparison between the two groups.
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