{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T15:01:49Z","timestamp":1785423709166,"version":"3.56.0"},"reference-count":63,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004504","name":"Research Council of Lithuania","doi-asserted-by":"publisher","award":["P-MIP-23-462"],"award-info":[{"award-number":["P-MIP-23-462"]}],"id":[{"id":"10.13039\/501100004504","id-type":"DOI","asserted-by":"publisher"}]},{"award":["P-MIP-23-462"],"award-info":[{"award-number":["P-MIP-23-462"]}],"id":[{"id":"https:\/\/ror.org\/02gs16m83","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>The formation of extracellular traps (ETs) through ETosis has emerged as a key mechanism in immunothrombosis. However, the temporal dynamics and clinical significance of ETosis in coronary thrombi of ST-elevation myocardial infarction (STEMI) patients remain incompletely understood. We investigated whether ETosis burden increases with thrombus age and is associated with DNASE1 and TREX1 genetic variants as well as impaired myocardial reperfusion. Thrombus aspirates from 81 STEMI patients undergoing primary percutaneous coronary intervention were histologically classified as fresh (n = 41) or lytic (n = 40). ETosis was quantified by citrullinated histone H3 (CitH3) immunohistochemistry and digital image analysis, complemented by multiplex staining for myeloperoxidase (MPO), CD68, caspase 3, and CD61. Plasma ET-related markers and genotyping of DNASE1 (rs1053874) and TREX1 (rs11797) were also performed. CitH3-positive cells were present in all thrombi but were more abundant in lytic (older) thrombi compared with fresh thrombi (1348 vs. 591 cells\/mm2, p &lt; 0.001). Increased ETosis was associated with neutrophil and macrophage infiltration, apoptosis, prolonged ischemia time, elevated systemic inflammation (neutrophil\u2013lymphocyte ratio and C-reactive protein), and impaired myocardial reperfusion (lower TIMI flow grades). Moreover, the DNASE1 GG genotype was associated with higher densities of MPO- and CD68-positive cells, whereas the TREX1 CC genotype was associated with increased densities of CitH3-, MPO-, and CD68-positive cells. This study demonstrates that ETosis increases with coronary thrombus maturation and is associated with local inflammation and impaired reperfusion in STEMI. Genetic variants in DNASE1 and TREX1 may modulate inflammatory cell accumulation within thrombi. These findings suggest ETosis as a potential therapeutic target, particularly in patients with delayed presentation.<\/jats:p>","DOI":"10.3390\/ijms27135998","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T15:15:04Z","timestamp":1783091704000},"page":"5998","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Extracellular Traps in Coronary Thrombus Aspirates from Patients with ST-Elevation Myocardial Infarction"],"prefix":"10.3390","volume":"27","author":[{"given":"Dalia","family":"Pangonyt\u0117","sequence":"first","affiliation":[{"name":"Laboratory of Cardiac Pathology, Institute of Cardiology, Lithuanian University of Health Sciences, 50162 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3365-2297","authenticated-orcid":false,"given":"Sandrita","family":"\u0160imonyt\u0117","sequence":"additional","affiliation":[{"name":"Laboratory of Molecular Cardiology, Institute of Cardiology, Lithuanian University of Health Sciences, 50162 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2736-3111","authenticated-orcid":false,"given":"Vaiva","family":"Lesauskait\u0117","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiac Pathology, Institute of Cardiology, Lithuanian University of Health Sciences, 50162 Kaunas, Lithuania"},{"name":"Laboratory of Molecular Cardiology, Institute of Cardiology, Lithuanian University of Health Sciences, 50162 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitalija","family":"Siratavi\u010di\u016bt\u0117","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiac Pathology, Institute of Cardiology, Lithuanian University of Health Sciences, 50162 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4113-004X","authenticated-orcid":false,"given":"Giedr\u0117","family":"Bak\u0161yt\u0117","sequence":"additional","affiliation":[{"name":"Heart Centre, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolanta","family":"Marcinkevi\u010dien\u0117","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiac Pathology, Institute of Cardiology, Lithuanian University of Health Sciences, 50162 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zita","family":"Stanionien\u0117","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiac Pathology, Institute of Cardiology, Lithuanian University of Health Sciences, 50162 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Utkien\u0117","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiac Pathology, Institute of Cardiology, Lithuanian University of Health Sciences, 50162 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina","family":"Jusien\u0117","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiac Pathology, Institute of Cardiology, Lithuanian University of Health Sciences, 50162 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reda","family":"Radik\u0117","sequence":"additional","affiliation":[{"name":"Laboratory of Cardiac Pathology, Institute of Cardiology, Lithuanian University of Health Sciences, 50162 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gediminas","family":"Jaru\u0161evi\u010dius","sequence":"additional","affiliation":[{"name":"Laboratory of Automation of Cardiovascular Investigation, Institute of Cardiology, Lithuanian University of Health Sciences, 50162 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ram\u016bnas","family":"Unikas","sequence":"additional","affiliation":[{"name":"Heart Centre, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Astra","family":"Vitkauskien\u0117","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivija","family":"Dobilien\u0117","sequence":"additional","affiliation":[{"name":"Heart Centre, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"e005375","DOI":"10.1161\/CIRCOUTCOMES.118.005375","article-title":"Mortality from ischemic heart disease: Analysis of data from the world health organization and coronary artery disease risk factors from NCD risk factor collaboration","volume":"12","author":"Nowbar","year":"2019","journal-title":"Circ. Cardiovasc. Qual. Outcomes"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Salari, N., Morddarvanjoghi, F., Abdolmaleki, A., Rasoulpoor, S., Khaleghi, A.A., Hezarkhani, K.A., Shohaimi, S., and Mohammadi, M. (2023). The global prevalence of myocardial infarction: A systematic review and meta-analysis. BMC Cardiovasc. Disord., 23.","DOI":"10.1186\/s12872-023-03231-w"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2866","DOI":"10.1093\/eurheartj\/ehaf289","article-title":"Acute coronary syndromes: Mechanisms, challenges, and new opportunities","volume":"46","author":"Kraler","year":"2025","journal-title":"Eur. Heart J."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Mignatti, A., Echarte-Morales, J., Sturla, M., and Latib, A. (2025). State of the art of primary PCI: Present and future. J. Clin. Med., 14.","DOI":"10.3390\/jcm14020653"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Ndrepepa, G., and Kastrati, A. (2023). Coronary no-reflow after primary percutaneous coronary intervention\u2014Current knowledge on pathophysiology, diagnosis, clinical impact and therapy. J. Clin. Med., 12.","DOI":"10.20944\/preprints202307.0902.v1"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e026849","DOI":"10.1161\/JAHA.122.026849","article-title":"The state of coronary thrombus aspiration","volume":"11","author":"Pruthi","year":"2022","journal-title":"J. Am. Heart Assoc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2032","DOI":"10.1161\/ATVBAHA.113.301627","article-title":"Elevated levels of circulating DNA and chromatin are independently associated with severe coronary atherosclerosis and a prothrombotic state","volume":"33","author":"Borissoff","year":"2013","journal-title":"Arterioscler. Thromb. Vasc. Biol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s12950-023-00344-z","article-title":"Neutrophil extracellular traps in acute coronary syndrome","volume":"20","author":"Wu","year":"2023","journal-title":"J. Inflamm."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Zdanyte, M., Borst, O., and M\u00fcnzer, P. (2023). NET-(works) in arterial and venous thrombo-occlusive diseases. Front. Cardiovasc. Med., 10.","DOI":"10.3389\/fcvm.2023.1155512"},{"key":"ref_10","first-page":"1205","article-title":"Neutrophil extracellular traps (NETs) in cardiovascular diseases: From molecular mechanisms to therapeutic interventions","volume":"81","author":"Natorska","year":"2023","journal-title":"Kardiol. Pol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"538","DOI":"10.1055\/s-0040-1708035","article-title":"Thrombo-inflammation in cardiovascular disease: An expert consensus document from the third Maastricht consensus conference on thrombosis","volume":"120","author":"Becker","year":"2020","journal-title":"Thromb. Haemost."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2306457","DOI":"10.1002\/advs.202306457","article-title":"Dying to defend: Neutrophil death pathways and their implications in immunity","volume":"11","author":"Tu","year":"2024","journal-title":"Adv. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"P\u00e9rez-Figueroa, E., \u00c1lvarez-Carrasco, P., Ortega, E., and Maldonado-Bernal, C. (2021). Neutrophils: Many ways to die. Front. Immunol., 12.","DOI":"10.3389\/fimmu.2021.631821"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1007\/s12272-025-01540-6","article-title":"The dynamic roles of macrophages extracellular traps (METs) in immune regulation","volume":"48","author":"Shin","year":"2025","journal-title":"Arch. Pharmacal Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1002\/path.5212","article-title":"Extracellular traps derived from macrophages, mast cells, eosinophils and neutrophils are generated in a time-dependent manner during atherothrombosis","volume":"247","author":"Pertiwi","year":"2019","journal-title":"J. Pathol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Han, Z., Liu, Q., Li, H., Zhang, M., You, L., Lin, Y., Wang, K., Gou, Q., Wang, Z., and Zhou, S. (2023). The role of monocytes in thrombotic diseases: A review. Front. Cardiovasc. Med., 10.","DOI":"10.3389\/fcvm.2023.1113827"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Zhou, Y., Xu, Z., and Liu, Z. (2022). Impact of neutrophil extracellular traps on thrombosis formation: New findings and future perspective. Front. Cell. Infect. Microbiol., 12.","DOI":"10.3389\/fcimb.2022.910908"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Zucoloto, A.Z., and Jenne, C.N. (2019). Platelet-neutrophil interplay: Insights into neutrophil extracellular trap (NET)-driven coagulation in infection. Front. Cardiovasc. Med., 6.","DOI":"10.3389\/fcvm.2019.00085"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Ma, Y., Zhang, J., Qi, Y., Lu, Y., Dong, Y., and Hu, D. (2025). Neutrophil extracellular traps in cardiovascular diseases: Pathological roles and therapeutic implications. Biomolecules, 15.","DOI":"10.3390\/biom15091263"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e23190","DOI":"10.1002\/jcla.23190","article-title":"Evaluation of neutrophil extracellular traps as the circulating marker for patients with acute coronary syndrome and acute ischemic stroke","volume":"34","author":"Lim","year":"2020","journal-title":"J. Clin. Lab. Anal."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1016\/j.thromres.2022.03.002","article-title":"Neutrophil extracellular traps (NETs) in patients with STEMI. Association with percutaneous coronary intervention and antithrombotic treatments","volume":"213","author":"Latorre","year":"2022","journal-title":"Thromb. Res."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.pathol.2021.05.099","article-title":"Erythrocyte interaction with neutrophil extracellular traps in coronary artery thrombosis following myocardial infarction","volume":"54","author":"Chilingaryan","year":"2022","journal-title":"Pathology"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1161\/CIRCRESAHA.116.304944","article-title":"Coronary neutrophil extracellular trap burden and deoxyribonuclease activity in ST-elevation acute coronary syndrome are predictors of ST-segment resolution and infarct size","volume":"116","author":"Mangold","year":"2015","journal-title":"Circ. Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1055\/a-1709-5271","article-title":"Prognostic implications of neutrophil extracellular traps in coronary thrombi of patients with ST-elevation myocardial infarction","volume":"122","author":"Blasco","year":"2022","journal-title":"Thromb. Haemost."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s00395-019-0740-3","article-title":"Neutrophil extracellular traps and fibrocytes in ST-segment elevation myocardial infarction","volume":"114","author":"Hofbauer","year":"2019","journal-title":"Basic Res. Cardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1161\/01.CIR.0000157141.00778.AC","article-title":"Plaque instability frequently occurs days or weeks before occlusive coronary thrombosis: A pathological thromboectomy study in primary percutaneous coronary intervention","volume":"111","author":"Rittersma","year":"2005","journal-title":"Circulation"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/j.jjcc.2016.10.003","article-title":"Inflammatory cell content of coronary thrombi is dependent on thrombus age in patients with ST-elevation myocardial infarction","volume":"69","author":"Fuijkschot","year":"2017","journal-title":"J. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1810","DOI":"10.1161\/CIRCULATIONAHA.108.780734","article-title":"Presence of older thrombus is an independent predictor of long-term mortality in patients with ST-elevation myocardial infarction treated with thrombus aspiration during primary percutaneous coronary intervention","volume":"118","author":"Kramer","year":"2008","journal-title":"Circulation"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"100439","DOI":"10.1016\/j.ijcha.2019.100439","article-title":"Etosis, rather than apoptosis or cell proliferation, typifies thrombus progression\u2014An immunohistochemical study of coronary aspirates","volume":"26","author":"Pertiwi","year":"2020","journal-title":"IJC Heart Vasc."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Laukov\u00e1, L., Kone\u010dn\u00e1, B., Janovi\u010dov\u00e1, \u013d., Vlkov\u00e1, B., and Celec, P. (2020). Deoxyribonucleases and their applications in biomedicine. Biomolecules, 10.","DOI":"10.3390\/biom10071036"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1007\/s00395-021-00864-w","article-title":"Deoxyribonuclease 1 Q222R single nucleotide polymorphism and long-term mortality after acute myocardial infarction","volume":"116","author":"Hofbauer","year":"2021","journal-title":"Basic Res. Cardiol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"2081","DOI":"10.1093\/eurheartj\/ehl177","article-title":"Association of Gln222Arg polymorphism in the deoxyribonuclease I (DNase I) gene with myocardial infarction in Japanese patients","volume":"27","author":"Kumamoto","year":"2006","journal-title":"Eur. Heart J."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1405","DOI":"10.1093\/eurheartj\/ehv007","article-title":"Expression of functional tissue factor by neutrophil extracellular traps in culprit artery of acute myocardial infarction","volume":"36","author":"Stakos","year":"2015","journal-title":"Eur. Heart J."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2074","DOI":"10.1111\/jth.12710","article-title":"Activated platelets present high mobility group box 1 to neutrophils, inducing autophagy and promoting the extrusion of neutrophil extracellular traps","volume":"12","author":"Maugeri","year":"2014","journal-title":"J. Thromb. Haemost."},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Pituk, D., Balogh, L., Horv\u00e1th, E., Hegyi, Z., Bar\u00e1th, B., Bog\u00e1ti, R., Sz\u0171cs, P., Papp, Z., Katona, \u00c9., and Bereczky, Z. (2024). Localization of hemostasis elements in aspirated coronary thrombi at different stages of evolution. Int. J. Mol. Sci., 25.","DOI":"10.3390\/ijms252111746"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.1016\/j.immuni.2025.03.020","article-title":"Immunothrombolytic monocyte-neutrophil axes dominate the single-cell landscape of human thrombosis and correlate with thrombus resolution","volume":"58","author":"Pekayvaz","year":"2025","journal-title":"Immunity"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.thromres.2016.07.003","article-title":"Time dependent apoptotic rates in the evolving coronary thrombus mass of myocardial infarction patients","volume":"145","author":"Maagdenberg","year":"2016","journal-title":"Thromb. Res."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Shirakawa, K., and Sano, M. (2022). Neutrophils and neutrophil extracellular traps in cardiovascular disease: An overview and potential therapeutic approaches. Biomedicines, 10.","DOI":"10.3390\/biomedicines10081850"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1186\/s40164-025-00670-3","article-title":"Exploring neutrophil extracellular traps: Mechanisms of immune regulation and future therapeutic potential","volume":"14","author":"Gao","year":"2025","journal-title":"Exp. Hematol. Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Bonaventura, A., Vecchi\u00e9, A., Abbate, A., and Montecucco, F. (2020). Neutrophil extracellular traps and cardiovascular diseases: An update. Cells, 9.","DOI":"10.3390\/cells9010231"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"eadm8715","DOI":"10.1126\/sciadv.adm8715","article-title":"Neutrophils only die twice","volume":"9","author":"Souza","year":"2023","journal-title":"Sci. Adv."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1186\/s43556-025-00337-9","article-title":"Neutrophil extracellular traps (NETs) in health and disease","volume":"6","author":"Shahzad","year":"2025","journal-title":"Mol. Biomed."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1007\/s12265-025-10676-1","article-title":"Characterization of neutrophil extracellular traps in acute myocardial infarction: A translational study","volume":"18","author":"Moreno","year":"2025","journal-title":"J. Cardiovasc. Transl. Res."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"5007","DOI":"10.1038\/s41598-020-61971-7","article-title":"Double-stranded DNA and NETs components in relation to clinical outcome after ST-elevation myocardial infarction","volume":"10","author":"Langseth","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"2182358","DOI":"10.1155\/2016\/2182358","article-title":"The time course of markers of neutrophil extracellular traps in patients undergoing revascularisation for acute myocardial infarction or stable angina pectoris","volume":"2016","author":"Helseth","year":"2016","journal-title":"Mediat. Inflamm."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.thromres.2024.01.015","article-title":"Analysis of NETs (neutrophil extracellular traps) in coronary thrombus and peripheral blood of patients with ST-segment elevation myocardial infarction","volume":"235","author":"Blasco","year":"2024","journal-title":"Thromb. Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1055\/s-0038-1641749","article-title":"Neutrophil extracellular traps participate in all different types of thrombotic and haemorrhagic complications of coronary atherosclerosis","volume":"118","author":"Pertiwi","year":"2018","journal-title":"Thromb. Haemost."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1228","DOI":"10.1161\/CIRCRESAHA.120.315931","article-title":"Neutrophil extracellular traps participate in cardiovascular diseases: Recent experimental and clinical insights","volume":"126","author":"Libby","year":"2020","journal-title":"Circ. Res."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/s00428-019-02662-1","article-title":"Diagnosis of myocardial infarction at autopsy: AECVP reappraisal in the light of the current clinical classification","volume":"476","author":"Michaud","year":"2019","journal-title":"Virchows Arch."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"423","DOI":"10.2143\/AC.63.4.2033039","article-title":"Out-of-hospital coronary heart disease death: Acute pathological lesions","volume":"63","author":"Stalioraityte","year":"2008","journal-title":"Acta Cardiol."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Demkow, U. (2023). Molecular mechanisms of neutrophil extracellular trap (NETs) degradation. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24054896"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"2398","DOI":"10.1161\/01.CIR.0000129232.61483.43","article-title":"Diagnostic use of serum deoxyribonuclease I activity as a novel early-phase marker in acute myocardial infarction","volume":"109","author":"Kawai","year":"2004","journal-title":"Circulation"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"eadj1397","DOI":"10.1126\/sciadv.adj1397","article-title":"NET formation is a default epigenetic program controlled by PAD4 in apoptotic neutrophils","volume":"9","author":"Zhu","year":"2023","journal-title":"Sci. Adv."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"13660","DOI":"10.1038\/s41598-019-49935-y","article-title":"Evaluation of the functional effects of genetic variants\u2013missense and nonsense SNPs, indels and copy number variations\u2013in the gene encoding human deoxyribonuclease I potentially implicated in autoimmunity","volume":"9","author":"Ueki","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"4277","DOI":"10.1038\/s41467-022-32055-z","article-title":"Structural basis of human TREX1 DNA degradation and autoimmune disease","volume":"13","author":"Zhou","year":"2022","journal-title":"Nat. Commun."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1055\/a-1733-9217","article-title":"Neutrophil extracellular traps in the infarct-related coronary artery\u2014A marker or mediator of adverse outcome?","volume":"122","author":"Gorog","year":"2022","journal-title":"Thromb. Haemost."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"2006","DOI":"10.1093\/cvr\/cvab217","article-title":"Culprit site extracellular DNA and microvascular obstruction in ST-elevation myocardial infarction","volume":"118","author":"Mangold","year":"2022","journal-title":"Cardiovasc. Res."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1093\/eurheartj\/ehy462","article-title":"Fourth universal definition of myocardial infarction (2018)","volume":"40","author":"Thygesen","year":"2019","journal-title":"Eur. Heart J."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.5858\/arpa.2013-0610-CP","article-title":"Principles of analytic validation of immunohistochemical assays: Guideline from the College of American Pathologists Pathology and Laboratory Quality Center","volume":"138","author":"Fitzgibbons","year":"2014","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/PAI.0000000000000163","article-title":"Standardization of positive controls in diagnostic immunohistochemistry: Recommendations from the international ad hoc expert committee","volume":"23","author":"Torlakovic","year":"2015","journal-title":"Appl. Immunohistochem. Mol. Morphol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"16878","DOI":"10.1038\/s41598-017-17204-5","article-title":"QuPath: Open source software for digital pathology image analysis","volume":"7","author":"Bankhead","year":"2017","journal-title":"Sci. Rep."},{"key":"ref_62","doi-asserted-by":"crossref","unstructured":"Fauzi, M.F.A., Ahmad, W.S.H.M.W., Jamaluddin, M.F., Lee, J.T.H., Khor, S.Y., Looi, L.M., Abas, F.S., and Aldahoul, N. (2022). Allred Scoring of ER-IHC Stained Whole-Slide Images for Hormone Receptor Status in Breast Carcinoma. Diagnostics, 12.","DOI":"10.3390\/diagnostics12123093"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1002\/pro.3307","article-title":"The human protein atlas: A spatial map of the human proteome","volume":"27","author":"Thul","year":"2018","journal-title":"Protein Sci."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/13\/5998\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T04:11:32Z","timestamp":1783915892000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/27\/13\/5998"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,3]]},"references-count":63,"journal-issue":{"issue":"13","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["ijms27135998"],"URL":"https:\/\/doi.org\/10.3390\/ijms27135998","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,3]]}}}