Document Detail

Bacterial signatures in thrombus aspirates of patients with myocardial infarction.
MedLine Citation:
PMID:  23418311     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Infectious agents, especially bacteria and their components originating from the oral cavity or respiratory tract, have been suggested to contribute to inflammation in the coronary plaque, leading to rupture and the subsequent development of coronary thrombus. We aimed to measure bacterial DNA in thrombus aspirates of patients with ST-segment-elevation myocardial infarction and to check for a possible association between bacteria findings and oral pathology in the same cohort.
METHODS AND RESULTS: Thrombus aspirates and arterial blood from patients with ST-segment-elevation myocardial infarction undergoing primary percutaneous coronary intervention (n=101; 76% male; mean age, 63.3 years) were analyzed with real-time quantitative polymerase chain reaction with specific primers and probes to detect bacterial DNA from several oral species and Chlamydia pneumoniae. The median value for the total amount of bacterial DNA in thrombi was 16 times higher than that found in their blood samples. Bacterial DNA typical for endodontic infection, mainly oral viridans streptococci, was measured in 78.2% of thrombi, and periodontal pathogens were measured in 34.7%. Bacteria-like structures were detected by transmission electron microscopy in all 9 thrombus samples analyzed; whole bacteria were detected in 3 of 9 cases. Monocyte/macrophage markers for bacteria recognition (CD14) and inflammation (CD68) were detected in thrombi (8 of 8) by immunohistochemistry. Among the subgroup of 30 patients with myocardial infarction examined by panoramic tomography, a significant association between the presence of periapical abscesses and oral viridans streptococci DNA-positive thrombi was found (odds ratio, 13.2; 95% confidence interval, 2.11-82.5; P=0.004).
CONCLUSIONS: Dental infection and oral bacteria, especially viridans streptococci, may be associated with the development of acute coronary thrombosis.
Tanja Pessi; Vesa Karhunen; Pasi P Karjalainen; Antti Ylitalo; Juhani K Airaksinen; Matti Niemi; Mikko Pietila; Kari Lounatmaa; Teppo Haapaniemi; Terho Lehtimäki; Reijo Laaksonen; Pekka J Karhunen; Jussi Mikkelsson
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2013-02-15
Journal Detail:
Title:  Circulation     Volume:  127     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-03-19     Completed Date:  2013-07-01     Revised Date:  2013-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1219-28, e1-6     Citation Subset:  AIM; IM    
Department of Forensic Science, School of Medicine, FIN-33014 Tampere University, Finland.
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MeSH Terms
Antigens, CD / metabolism
Antigens, CD14 / metabolism
Antigens, Differentiation, Myelomonocytic / metabolism
Biological Markers / metabolism
Biopsy, Needle
DNA, Bacterial / metabolism
Macrophages / metabolism
Middle Aged
Mouth Diseases / complications*,  microbiology
Myocardial Infarction / etiology*
Retrospective Studies
Stomatognathic Diseases / complications*,  microbiology
Thrombosis / complications,  microbiology*,  pathology*
Viridans Streptococci / genetics,  isolation & purification*
Reg. No./Substance:
0/Antigens, CD; 0/Antigens, CD14; 0/Antigens, Differentiation, Myelomonocytic; 0/Biological Markers; 0/CD68 antigen, human; 0/DNA, Bacterial
Comment In:
Circulation. 2013 Oct 8;128(15):e235   [PMID:  24100486 ]
Circulation. 2013 Oct 8;128(15):e237-8   [PMID:  24100488 ]
Circulation. 2013 Oct 8;128(15):e236   [PMID:  24100487 ]

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