Fractal dimension: A novel clot microstructure biomarker use in ST elevation myocardial infarction patients

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. Ge...

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Bibliographic Details
Published in:Atherosclerosis 2015-06, Vol.240 (2), p.402-407
Main Authors: Lawrence, Matthew J, Sabra, Ahmed, Thomas, Phillip, Obaid, Daniel R, D'Silva, Lindsay A, Morris, Roger H.K, Hawkins, Karl, Brown, Martin R, Williams, Phylip R, Davidson, Simon J, Chase, Alexander J, Smith, David, Evans, Phillip A
Format: Article
Language:English
Subjects:
Acute myocardial infarction
Aged
Aged, 80 and over
Anticoagulants - therapeutic use
Blood Coagulation - drug effects
Blood Coagulation Tests - methods
Cardiovascular
Coagulation
Coronary Angiography
Coronary Thrombosis - blood
Coronary Thrombosis - diagnosis
Coronary Thrombosis - therapy
Drug monitoring
Elasticity
Feasibility Studies
Female
Fibrinolytic Agents - therapeutic use
Fractal dimension
Fractals
Gel Point
Humans
Male
Microscopy, Electron, Scanning
Middle Aged
Myocardial Infarction - blood
Myocardial Infarction - diagnosis
Myocardial Infarction - therapy
Percutaneous Coronary Intervention
Platelet Aggregation
Platelet Aggregation Inhibitors - therapeutic use
Point-of-Care Testing
Predictive Value of Tests
Prospective Studies
Reproducibility of Results
Time Factors
Treatment Outcome
Viscosity
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Summary: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 ( d f )), real-time clot formation time ( T GP ) 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 d f after pPCI was lower than d f on admission (mean 1.631 [SD 0.063] vs 1.751 [0.052], p 
ISSN:0021-9150
1879-1484
DOI:10.1016/j.atherosclerosis.2015.04.012