Estudio de la presencia de ADN bacteriano en trombos intracoronarios en pacientes con infarto agudo de miocardio

Abstract

This doctoral thesis is an observational study in patients with ST-segment elevation myocardial infarction (STEMI) in our geographical area treated with coronary intervention. The presence, prevalence, and variety of bacteria in thrombi have never been studied in Galician patients. The objective was to detect bacterial deoxyribonucleic acid (DNA) in thrombotic material from patients with STEMI. We included 109 consecutive patients in whom coronary thrombus was obtained by thromboaspiration, and one peripheral blood sample. The presence of bacterial DNA was analysed by probe-based real-time Polymerase Chain Reaction (PCR). The presence of: Aggregatibacter actinomycetemcomitans, Chlamydia pneumoniae, viridans group streptococci, Porphyromonas gingivalis, Fusobacterium nucleatum, Tannarella forsythia, Treponema denticola, Helycobacter pylori, Mycoplasma pneumoniae, Staphylococus aureus, Prevotella intermedia, and Streptococcus mutans was studied. Bacterial DNA from 4 species was detected in 9,2% of the patients studied: viridans group streptococci, (5.5%), followed by Staphylococcus aureus (1.8%); Porphyromonas gingivalis and Prevotella intermedia (0.9% respectively). No bacterial DNA was detected in peripheral blood. In conclusion, DNA from 4 bacterial species is present in thrombi from a small proportion of STEMI patients. Bacteria could be latently present in plaques and might play a role in plaque instability and thrombus formation leading to STEMI in these patients.