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

Matthew Lawrence, Ahmed Sabra, Phillip Thomas, Daniel Obaid Orcid Logo, Lindsay D´Silva, Roger H.K. Morris, Karl Hawkins Orcid Logo, Rowan Brown Orcid Logo, Rhodri Williams Orcid Logo, Simon J. Davidson, Alexander J. Chase, David Smith, Adrian Evans Orcid Logo

Atherosclerosis, Volume: 240, Issue: 2, Pages: 402 - 407

Swansea University Authors: Matthew Lawrence, Ahmed Sabra, Daniel Obaid Orcid Logo, Lindsay D´Silva, Karl Hawkins Orcid Logo, Rowan Brown Orcid Logo, Rhodri Williams Orcid Logo, Adrian Evans Orcid Logo

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DOI (Published version): 10.1016/j.atherosclerosis.2015.04.012

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ObjectivesChanges 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 ma...

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Published in: Atherosclerosis
ISSN: 0021-9150
Published: Elsevier BV 2015
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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&#x2032;GP)).MethodsWe 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).Resultsdf after pPCI was lower than df on admission (mean 1.631 [SD 0.063] vs 1.751 [0.052], p &lt; 0.000001) whereas df at 24 h was similar to that on admission. G&#x2032;GP also showed similar trend to df (p &lt; 0.001). TGP was prolonged at after-PCI measurement compared with admission (median 854 s [IQR 581&#x2013;1801] vs 217 [179&#x2013;305], p &lt; 0.00001). Changes in the values of df and G&#x2032;GP were consistent with changes in the SEM images of the mature clot.ConclusionsWe characterise Gel Point derived markers of clot microstructure in patients admitted with emergency arterial thrombosis. 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spelling 2022-11-02T16:31:33.0760295 v2 27876 2016-05-13 Fractal dimension: A novel clot microstructure biomarker use in ST elevation myocardial infarction patients 262d0cae7663ded863d6e2de15757f3c Matthew Lawrence Matthew Lawrence true false 97b3ad56338338453cbee42046817655 Ahmed Sabra Ahmed Sabra true false 1cb4b49224d4f3f2b546ed0f39e13ea8 0000-0002-3891-1403 Daniel Obaid Daniel Obaid true false 01ccf114efd431d0cab9b3ef591d7f02 Lindsay D´Silva Lindsay D´Silva true false 77c39404a9a98c6e2283d84815cba053 0000-0003-0174-4151 Karl Hawkins Karl Hawkins true false d7db8d42c476dfa69c15ce06d29bd863 0000-0003-3628-2524 Rowan Brown Rowan Brown true false 642bf793695f412ed932f1ea4d9bc3f1 0000-0002-6912-5288 Rhodri Williams Rhodri Williams true false 21761f6eb805546a561c9f036e85405b 0000-0002-0814-5162 Adrian Evans Adrian Evans true false 2016-05-13 BMS ObjectivesChanges 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)).MethodsWe 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).Resultsdf 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.ConclusionsWe 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. Journal Article Atherosclerosis 240 2 402 407 Elsevier BV 0021-9150 1 6 2015 2015-06-01 10.1016/j.atherosclerosis.2015.04.012 COLLEGE NANME Biomedical Sciences COLLEGE CODE BMS Swansea University 2022-11-02T16:31:33.0760295 2016-05-13T13:06:46.4210708 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Medicine Matthew Lawrence 1 Ahmed Sabra 2 Phillip Thomas 3 Daniel Obaid 0000-0002-3891-1403 4 Lindsay D´Silva 5 Roger H.K. Morris 6 Karl Hawkins 0000-0003-0174-4151 7 Rowan Brown 0000-0003-3628-2524 8 Rhodri Williams 0000-0002-6912-5288 9 Simon J. Davidson 10 Alexander J. Chase 11 David Smith 12 Adrian Evans 0000-0002-0814-5162 13 0027876-22032018141423.pdf 27876.pdf 2018-03-22T14:14:23.5470000 Output 827107 application/pdf Accepted Manuscript true 2019-04-25T00:00:00.0000000 false eng
title Fractal dimension: A novel clot microstructure biomarker use in ST elevation myocardial infarction patients
spellingShingle Fractal dimension: A novel clot microstructure biomarker use in ST elevation myocardial infarction patients
Matthew Lawrence
Ahmed Sabra
Daniel Obaid
Lindsay D´Silva
Karl Hawkins
Rowan Brown
Rhodri Williams
Adrian Evans
title_short Fractal dimension: A novel clot microstructure biomarker use in ST elevation myocardial infarction patients
title_full Fractal dimension: A novel clot microstructure biomarker use in ST elevation myocardial infarction patients
title_fullStr Fractal dimension: A novel clot microstructure biomarker use in ST elevation myocardial infarction patients
title_full_unstemmed Fractal dimension: A novel clot microstructure biomarker use in ST elevation myocardial infarction patients
title_sort Fractal dimension: A novel clot microstructure biomarker use in ST elevation myocardial infarction patients
author_id_str_mv 262d0cae7663ded863d6e2de15757f3c
97b3ad56338338453cbee42046817655
1cb4b49224d4f3f2b546ed0f39e13ea8
01ccf114efd431d0cab9b3ef591d7f02
77c39404a9a98c6e2283d84815cba053
d7db8d42c476dfa69c15ce06d29bd863
642bf793695f412ed932f1ea4d9bc3f1
21761f6eb805546a561c9f036e85405b
author_id_fullname_str_mv 262d0cae7663ded863d6e2de15757f3c_***_Matthew Lawrence
97b3ad56338338453cbee42046817655_***_Ahmed Sabra
1cb4b49224d4f3f2b546ed0f39e13ea8_***_Daniel Obaid
01ccf114efd431d0cab9b3ef591d7f02_***_Lindsay D´Silva
77c39404a9a98c6e2283d84815cba053_***_Karl Hawkins
d7db8d42c476dfa69c15ce06d29bd863_***_Rowan Brown
642bf793695f412ed932f1ea4d9bc3f1_***_Rhodri Williams
21761f6eb805546a561c9f036e85405b_***_Adrian Evans
author Matthew Lawrence
Ahmed Sabra
Daniel Obaid
Lindsay D´Silva
Karl Hawkins
Rowan Brown
Rhodri Williams
Adrian Evans
author2 Matthew Lawrence
Ahmed Sabra
Phillip Thomas
Daniel Obaid
Lindsay D´Silva
Roger H.K. Morris
Karl Hawkins
Rowan Brown
Rhodri Williams
Simon J. Davidson
Alexander J. Chase
David Smith
Adrian Evans
format Journal article
container_title Atherosclerosis
container_volume 240
container_issue 2
container_start_page 402
publishDate 2015
institution Swansea University
issn 0021-9150
doi_str_mv 10.1016/j.atherosclerosis.2015.04.012
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Medicine{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Medicine
document_store_str 1
active_str 0
description ObjectivesChanges 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)).MethodsWe 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).Resultsdf 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.ConclusionsWe 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.
published_date 2015-06-01T03:33:51Z
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