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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
CD142+/CD61+, CD146+ and CD45+ microparticles predict cardiovascular events in high risk patients following a
Gemma Chiva-Blanch, Javier Crespo, Rosa Suades
1Prof. Lina Badimon, Cardiovascular Research Center - CSIC-ICCC, Hospital de la Santa Creu i Sant Pau, Av. S. Antoni M. Claret, 167 Barcelona 08025, Spain, Tel.: +34 93 556 58 80, Fax: +34 93 556 55 59,
Abstract:
Circulating microparticles (cMPs) are small phospholipid-rich microvesicles shed by activated cells that play a pivotal role in cell signalling related to the pathogenesis of atherothrombosis. We aimed to investigate the prognostic value of cMPs released from different vascular cells for cardiovascular event (CVE) presentation in asymptomatic patients at high cardiovascular risk factors under nutritional and pharmacologic treatment. This is a nested case-control study of 50 patients from the five-year follow-up prospective PREDIMED trial enrolled in the nuts arm of the Mediterranean diet (MedDiet-nuts). We randomly selected 25 patients who had suffered a CVE during follow-up and pair-matched them for sex, age, and classical CV risk factors to 25 patients who remained asymptomatic (no-CVE). Total Annexin V-(AV)+ cMPs and cMPs from cells of the vascular compartment were quantified by flow cytometry at baseline and after one year follow-up. MedDiet-nuts and pharmacological treatment neither modified levels nor source of MP shedding in CVE patients. However, no-CVE patients showed 40-86 % decreased total AV+, PAC-1+/AV+, CD61+/AV+, CD142+/CD61+/AV+, CD62P+/AV+, CD146+/AV+, CD63+/AV+ and CD11a+/AV+ cMPs at one year follow-up (p≤0.046, all). CD142+/CD61+/AV+, CD146+/AV+ and CD45+/AV+ cMPs were decreased in no-CVE patients compared to CVE patients. A ROC-curve clustered model for CD142+/CD61+/AV+, CD45+/AV+ and CD146+/AV+ cMPs predicted a future CVE [p<0.0001, AUC=0.805 (0.672 to 0.938)]. In patients at high CV risk profile treated with a controlled MedDiet supplemented with nuts and receiving up-to-date CV drug treatment, reduced cMPs derived from activated platelets, leukocytes and endothelial cells are predictive of protection against CVE within the next four years.
Insights
Reduced circulating microparticles (cMPs) from activated platelets, leukocytes, and endothelial cells predict fewer cardiovascular events (CVEs) in high-risk patients. This finding offers prognostic value for CVE presentation in treated individuals.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Atherothrombosis Research
Background:
- Circulating microparticles (cMPs) are key mediators in atherothrombosis pathogenesis.
- Assessing cMPs' prognostic value is crucial for cardiovascular event (CVE) prediction in high-risk populations.
Purpose of the Study:
- To evaluate the prognostic significance of cMPs from various vascular cells for CVE presentation.
- To determine if nutritional (Mediterranean diet with nuts) and pharmacological treatments influence cMP shedding.
Main Methods:
- A nested case-control study within the PREDIMED trial (MedDiet-nuts arm).
- 50 high-risk patients (25 CVEs, 25 no-CVEs) matched for sex, age, and risk factors.
- Flow cytometry quantified total Annexin V+ cMPs and specific vascular cell-derived cMPs at baseline and 1-year follow-up.
Main Results:
- Treatments did not alter cMP levels or shedding sources in CVE patients.
- No-CVE patients exhibited significantly decreased cMPs (Annexin V+, PAC-1+, CD61+, CD142+/CD61+, CD62P+, CD146+, CD63+, CD11a+) at 1 year.
- Lower levels of CD142+/CD61+/AV+, CD146+/AV+, and CD45+/AV+ cMPs distinguished no-CVE from CVE patients.
- A predictive model using CD142+/CD61+/AV+, CD45+/AV+, and CD146+/AV+ cMPs accurately predicted future CVEs (AUC=0.805).
Conclusions:
- Reduced cMPs from activated platelets, leukocytes, and endothelial cells are protective against CVEs in high-risk patients on MedDiet and standard treatment.
- Specific cMP subsets serve as valuable prognostic biomarkers for cardiovascular events.
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