Polyhedral erythrocytes in intracoronary thrombus and their association with reperfusion in myocardial infarction

  • Jaroslaw ZalewskiEmail author
  • Lukasz Lewicki
  • Krzysztof Krawczyk
  • Michal Zabczyk
  • Radoslaw Targonski
  • Patrycja Molek
  • Jadwiga Nessler
  • Anetta Undas
Original Paper



The tightly packed arrays of polyhedral erythrocytes, polyhedrocytes, formed during thrombus contraction, have been detected in some intracoronary thrombi (ICT) obtained from patients with ST-segment elevation myocardial infarction (STEMI). We sought to investigate determinants of polyhedrocyte content in ICT and its association with reperfusion in STEMI.


We assessed the composition of ICT obtained during thrombectomy within 12 h since the symptom onset in 110 STEMI patients, following 300 mg of aspirin (n = 110) and 600 mg of clopidogrel (n = 75). The predominance of fibrin, erythrocytes, polyhedrocytes or platelets was evaluated using scanning electron microscopy.


Polyhedrocytes were found in 34 (30.9%) ICT, in which they covered 20–50% (median 38.8%) fields of view. Patients with polyhedrocytes in ICT had lower median minimal reference infarct-related artery (IRA) diameter by 20% (p < 0.0001) and area by 31% (p < 0.0001) versus those without polyhedrocytes. Time of ischemia showed association with the polyhedrocyte content (r = 0.26, p = 0.007). By multivariate analysis, minimal IRA diameter (β = − 0.50, p < 0.0001) and ischemia time (β = 0.20, p = 0.035) independently affected polyhedrocyte content in ICT (R2 = 0.45, p < 0.0001). Patients with ischemia time of > 3 h and polyhedrocytes present in ICT had more frequently TIMI-2/3 flow after thrombus aspiration (96% vs. 67%, p = 0.02) and final TIMI-2/3 myocardial perfusion grade (92% vs. 57%, p = 0.044) versus those without polyhedrocytes.


Our findings indicate that the presence of polyhedrocytes in ICT, observed in one-third of STEMI patients, is associated with smaller minimal IRA diameter, prolonged ischemia and their formation in late presenters is associated with more effective thrombus aspiration and better myocardial reperfusion.


Polyhedrocytes Thrombus Myocardial infarction Scanning electron microscopy 



This work was supported by grants of the Jagiellonian University Medical College (K/ZDS/006441) and by National Science Centre Poland (2016/21/B/NZ5/01378).

Compliance with ethical standards

Conflict of interest

The authors have nothing to disclose in relation to this study.

Supplementary material

392_2019_1425_MOESM1_ESM.doc (535 kb)
Supplementary material 1 (DOC 535 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Coronary Artery DiseaseJagiellonian University Medical CollegeKrakowPoland
  2. 2.Gdansk University of TechnologyGdanskPoland
  3. 3.Pomeranian Cardiology CentersWejherowoPoland
  4. 4.Department of Experimental Cardiac Surgery, Anesthesiology and CardiologyJagiellonian University Medical CollegeKrakowPoland

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