Julia Novotny1, Paul Oberdieck1, Anna Titova1, Jaroslav Pelisek1, Sue Chandraratne1, Philipp Nicol1, Alexander Hapfelmeier1, Michael Joner1, Lars Maegdefessel1, Holger Poppert1, Joachim Pircher1, Steffen Massberg1, Benjamin Friedrich1, Claus Zimmer1, Christian Schulz2, Tobias Boeckh-Behrens2. 1. From the Medizinische Klinik und Poliklinik I (J.N., P.O., A.T., S.C., J. Pircher, S.M., C.S.), Klinikum der Universität München, Ludwig-Maximilians-Universität; DZHK (German Center for Cardiovascular Research) (J.N., P.N., M.J., L.M., J. Pircher, S.M., C.S.), Partner Site Munich Heart Alliance; Klinik und Poliklinik für Vaskuläre und Endovaskuläre Chirurgie (J. Pelisek, L.M.), Klinikum rechts der Isar, Technische Universität München; Deutsches Herzzentrum München (P.N., M.J.), Technische Universität München; Institute of Medical Informatics (A.H.), Statistics and Epidemiology, School of Medicine, Technische Universität München; Neurologische Klinik und Poliklinik (H.P.), Klinikum rechts der Isar, Technische Universität München; and Abteilung für Diagnostische und Interventionelle Neuroradiologie (B.F., C.Z., T.B.-B.), Klinikum rechts der Isar, Technische Universität München, Germany. 2. From the Medizinische Klinik und Poliklinik I (J.N., P.O., A.T., S.C., J. Pircher, S.M., C.S.), Klinikum der Universität München, Ludwig-Maximilians-Universität; DZHK (German Center for Cardiovascular Research) (J.N., P.N., M.J., L.M., J. Pircher, S.M., C.S.), Partner Site Munich Heart Alliance; Klinik und Poliklinik für Vaskuläre und Endovaskuläre Chirurgie (J. Pelisek, L.M.), Klinikum rechts der Isar, Technische Universität München; Deutsches Herzzentrum München (P.N., M.J.), Technische Universität München; Institute of Medical Informatics (A.H.), Statistics and Epidemiology, School of Medicine, Technische Universität München; Neurologische Klinik und Poliklinik (H.P.), Klinikum rechts der Isar, Technische Universität München; and Abteilung für Diagnostische und Interventionelle Neuroradiologie (B.F., C.Z., T.B.-B.), Klinikum rechts der Isar, Technische Universität München, Germany. christian.schulz@med.uni-muenchen.de boeckh-behrens@tum.de.
Abstract
OBJECTIVE: To investigate whether immune cell composition and content of neutrophil extracellular traps (NETs) in relation to clinical outcome are different between acute ischemic stroke (AIS) and acute myocardial infarction (AMI), we performed histologic analysis and correlated results with clinical and procedural parameters. METHODS: We retrieved thrombi from patients with AIS (n = 71) and AMI (n = 72) during endovascular arterial recanalization and analyzed their immune cell composition and NET content by immunohistology. We then associated thrombus composition with procedural parameters and outcome in AIS and with cardiac function in patients with AMI. Furthermore, we compared AIS thrombi with AMI thrombi and differentiated Trial of Org 10172 in Acute Stroke Treatment classifications to address potential differences in thrombus pathogenesis. RESULTS: Amounts of leukocytes (p = 0.133) and neutrophils (p = 0.56) were similar between AIS and AMI thrombi. Monocytes (p = 0.0052), eosinophils (p < 0.0001), B cells (p < 0.0001), and T cells (p < 0.0001) were more abundant in stroke compared with AMI thrombi. NETs were present in 100% of patients with AIS and 20.8% of patients with AMI. Their abundance in thrombi was associated with poor outcome scores in patients with AIS and with reduced ejection fraction in patients with AMI. CONCLUSION: In our detailed histologic analysis of arterial thrombi, thrombus composition and especially abundance of leukocyte subsets differed between patients with AIS and AMI. The presence and amount of NETs were associated with patients' outcome after AIS and AMI, supporting a critical impact of NETs on thrombus stability in both conditions.
OBJECTIVE: To investigate whether immune cell composition and content of neutrophil extracellular traps (NETs) in relation to clinical outcome are different between acute ischemic stroke (AIS) and acute myocardial infarction (AMI), we performed histologic analysis and correlated results with clinical and procedural parameters. METHODS: We retrieved thrombi from patients with AIS (n = 71) and AMI (n = 72) during endovascular arterial recanalization and analyzed their immune cell composition and NET content by immunohistology. We then associated thrombus composition with procedural parameters and outcome in AIS and with cardiac function in patients with AMI. Furthermore, we compared AIS thrombi with AMI thrombi and differentiated Trial of Org 10172 in Acute Stroke Treatment classifications to address potential differences in thrombus pathogenesis. RESULTS: Amounts of leukocytes (p = 0.133) and neutrophils (p = 0.56) were similar between AIS and AMI thrombi. Monocytes (p = 0.0052), eosinophils (p < 0.0001), B cells (p < 0.0001), and T cells (p < 0.0001) were more abundant in stroke compared with AMI thrombi. NETs were present in 100% of patients with AIS and 20.8% of patients with AMI. Their abundance in thrombi was associated with poor outcome scores in patients with AIS and with reduced ejection fraction in patients with AMI. CONCLUSION: In our detailed histologic analysis of arterial thrombi, thrombus composition and especially abundance of leukocyte subsets differed between patients with AIS and AMI. The presence and amount of NETs were associated with patients' outcome after AIS and AMI, supporting a critical impact of NETs on thrombus stability in both conditions.
Authors: Senna Staessens; Olivier François; Waleed Brinjikji; Karen M Doyle; Peter Vanacker; Tommy Andersson; Simon F De Meyer Journal: Stroke Date: 2021-09-14 Impact factor: 7.914
Authors: Vijay M Ravindra; Frederik Denorme; Matthew D Alexander; Robert A Campbell; Ramesh Grandhi Journal: Interv Neuroradiol Date: 2022-04-21 Impact factor: 1.764
Authors: Tetsuya Hashimoto; Takenobu Kunieda; Tristan Honda; Fabien Scalzo; Latisha K Sharma; Jason D Hinman; Neal M Rao; May Nour; Mersedeh Bahr-Hosseini; Jeffrey L Saver; Radoslav Raychev; David S Liebeskind Journal: Neuroradiol J Date: 2021-10-05
Authors: Chao Li; Chunyang Wang; Yi Zhang; Owais K Alsrouji; Alex B Chebl; Guangliang Ding; Quan Jiang; Stephan A Mayer; Mei Lu; Max K Kole; Horia L Marin; Li Zhang; Michael Chopp; Zheng Gang Zhang Journal: J Cereb Blood Flow Metab Date: 2021-02-08 Impact factor: 6.200
Authors: Fabian Essig; Alexander M Kollikowski; Mirko Pham; László Solymosi; Guido Stoll; Karl Georg Haeusler; Peter Kraft; Michael K Schuhmann Journal: Int J Mol Sci Date: 2020-10-07 Impact factor: 5.923