Atrial fibrillation and thrombosis

Immunohistochemical differences between in situ and embolized thrombi

W. E. Wysokinski, S. G. Owen, D. N. Fass, D. D. Patrzalek, L. Murphy, Robert D. McBane

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

Background/objective: Thromboembolism secondary to atrial fibrillation accounts for approximately one-fourth of all strokes. Although considerable resources have been targeted to pharmacologic prophylaxis, neither the cellular nor the biochemical composition of atrial thrombi is known. Quantitative immunohistochemistry was undertaken to define the composition of atrial thrombi and to explore morphological differences between atrial appendage thrombi and those that embolize. Patients/methods: Serial sections of thrombi obtained during valve replacement surgery or embolectomy from 22 patients with atrial fibrillation were stained with antibodies against fibrin, integrin β 3, or tissue factor and analyzed with NIH-image. Results: Thrombi showed distinct regions staining for either fibrin or platelets and on average, the fibrin-rich regions predominated (P < 0.0001). The platelet content of embolized thrombi was nearly twice that of atrial thrombi (P = 0.02). Non-staining amorphous material comprised nearly half of atrial thrombi in situ, but was rare in embolized thrombi (P < 0.001). Tissue factor colocalized to areas rich in platelets and granulocytes. Conclusions: The abundance of fibrin relative to platelets underscores the enhanced efficacy of warfarin prophylaxis in clinical trials. The finding of tissue factor localized to platelet-leukocyte clusters suggests its blood-borne origin. Compositional differences between in situ and embolized thrombi suggest directions for investigating propensity for embolization.

Original languageEnglish (US)
Pages (from-to)1637-1644
Number of pages8
JournalJournal of Thrombosis and Haemostasis
Volume2
Issue number9
DOIs
StatePublished - Sep 2004

Fingerprint

Atrial Fibrillation
Thrombosis
Fibrin
Blood Platelets
Thromboplastin
Embolectomy
Atrial Appendage
Thromboembolism
Warfarin
Granulocytes
Integrins
Leukocytes
Immunohistochemistry
Stroke
Clinical Trials
Staining and Labeling
Antibodies

Keywords

  • Atrial fibrillation
  • Fibrin
  • Platelet
  • Thrombosis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Atrial fibrillation and thrombosis : Immunohistochemical differences between in situ and embolized thrombi. / Wysokinski, W. E.; Owen, S. G.; Fass, D. N.; Patrzalek, D. D.; Murphy, L.; McBane, Robert D.

In: Journal of Thrombosis and Haemostasis, Vol. 2, No. 9, 09.2004, p. 1637-1644.

Research output: Contribution to journalArticle

Wysokinski, W. E. ; Owen, S. G. ; Fass, D. N. ; Patrzalek, D. D. ; Murphy, L. ; McBane, Robert D. / Atrial fibrillation and thrombosis : Immunohistochemical differences between in situ and embolized thrombi. In: Journal of Thrombosis and Haemostasis. 2004 ; Vol. 2, No. 9. pp. 1637-1644.
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