Highlights
- •We performed a study using a new coagulation biomarker in myocardial infarction.
- •The new biomarker measures how quick the clot forms, its strength and structure.
- •Therapeutic intervention caused significant changes in clot structure.
- •Changes in the new biomarker were consistent with standard SEM images of the clot.
Abstract
Objectives
Changes in clot microstructure are increasingly implicated in the pathology of atherosclerosis
although most data are from techniques in the remote laboratory using altered blood.
We validate the novel biomarker Gel Point in STEMI patients and assess therapeutic
interventions. Gel Point marks the transition of blood from a visco-elastic liquid
to visco-elastic solid and is rapidly measured using unadulterated blood. The Gel
Point provides measurements of three parameters to reflect clot microstructure (fractal
dimension (df)), real-time clot formation time (TGP) and blood clot strength (elasticity at the Gel Point (G′GP)).
Methods
We prospectively recruited 38 consecutive patients with STEMI undergoing primary percutaneous
coronary intervention (pPCI). Venous blood samples were collected on admission, after
pPCI and 24 h after admission for assessment of the new biomarkers, standard coagulation
tests and scanning electron microscopy (SEM).
Results
df after pPCI was lower than df on admission (mean 1.631 [SD 0.063] vs 1.751 [0.052], p < 0.000001) whereas df at 24 h was similar to that on admission. G′GP also showed similar trend to df (p < 0.001). TGP was prolonged at after-PCI measurement compared with admission (median 854 s [IQR
581–1801] vs 217 [179–305], p < 0.00001). Changes in the values of df and G′GP were consistent with changes in the SEM images of the mature clot.
Conclusions
We characterise Gel Point derived markers of clot microstructure in patients admitted
with emergency arterial thrombosis. This point of care test can potentially be used
to assess the efficacy of therapeutic interventions by measuring changes in clot microstructure.
Keywords
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Article info
Publication history
Published online: April 13, 2015
Accepted:
April 6,
2015
Received in revised form:
March 12,
2015
Received:
January 16,
2015
Identification
Copyright
© 2015 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
