Rello, PauGarcía Del Blanco, BrunoRuiz-Meana, MarisolMiro-Casas, ElisabetAlfonso, FernandoGarcía-Picart, JoanBarrabés, José ABorrás, GuillermoMartin, PilarDorado, David GarcíaSambola, Antonia2020-04-032020-04-032020-02Thromb Res. 2020; 186:64-700049-3848http://hdl.handle.net/20.500.12105/9438OBJECTIVES: To characterize sex differences in the composition of coronary thrombus in patients with ST-segment elevation myocardial infarction (STEMI), especially in the young (age ≤ 55 years). BACKGROUND: Women have smaller coronary vessels than men and their vascular lesions can be influenced by different exposure to circulating estrogens throughout life. These factors could determine a different composition of the coronary thrombus in women with STEMI. METHODS: A prospective, multicenter study was conducted on patients with STEMI and coronary thrombus was aspirated immediately before percutaneous coronary intervention (PCI) using a suction catheter (ProntoV3® or Export®). Histopathology, immunohistochemistry and ELISA techniques were used for the quantitative determination of fibrin, p-selectin and von Willebrand factor (vWF) within thrombi. RESULTS: Thrombi were collected from 100 patients (50 men and 50 women; 13 women and 13 men of <55 years). Women presented similar baseline characteristics and pain-to-balloon elapsed time than men. Thrombi from women showed a trend to a lower concentration of fibrin than those from men [median = 1.2 ng/mg (IQR 3.5) vs median = 2.2 ng/mg (IQR 5.9), p = 0.102]. No differences were found between sexes in p-selectin and vWF concentration in thrombi. However, thrombi from young women showed lower levels of p-selectin [median = 2.2 ng/mg (IQR 4.5) vs 6.5 ng/mg (IQR 4.8), p = 0.004], fibrin [median = 1.1 ng/mg; (IQR: 3.4) vs 4.1 ng/mg (IQR 15.6), p = 0.014] and vWF [median = 3.2 ng/mg (IQR 10.6) vs 25.8 ng/mg (IQR 15.0), p = 0.003] than those from young men. CONCLUSIONS: Thrombi from young women with STEMI showed a lower content of fibrin, p-selectin and vWF than those from men.engAMhttp://creativecommons.org/licenses/by-nc-nd/4.0/ST-elevation myocardial infarctionThrombusWomenAttribution-NonCommercial-NoDerivatives 4.0 Internacional3188762518664-7010.1016/j.thromres.2019.12.0101879-2472Thrombosis researchopen access