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Published on: July 3, 2018
Platelet-, monocyte-derived and tissue factor-carrying circulating microparticles are related to acute myocardial
Gemma Chiva-Blanch1,2,3, Kristian Laake1,2, Peder Myhre1,2
1Centre for Clinical Heart Research, Department of Cardiology, Oslo University Hospital Ullevål, Oslo, Norway.
Objective:
Circulating microparticles (cMPs) are phospholipid-rich vesicles released from cells when activated or injured, and contribute to the formation of intracoronary thrombi. Tissue factor (TF, CD142) is the main trigger of fibrin formation and TF-carrying cMPs are considered one of the most procoagulant cMPs. Similar types of atherosclerotic lesions may lead to different types of AMI, although the mechanisms behind are unresolved. Therefore, we aimed to investigate the phenotype of cMPs found in plasma of ACS patients and its relation to AMI severity and thrombotic burden.
Methods:
In a cross-sectional study, two hundred patients aged 75±4 years were included in the study 2-8 weeks after suffering an AMI. Annexin V positive (AV+)-cMPs derived from blood and vascular cells were measured by flow cytometry. Plasma procoagulant activity (TF-PCA) was measured through a chromogenic assay.
Results:
STEMI patients (n = 75) showed higher levels of platelet-derived cMPs [CD61+/AV+, CD31+/AV+, CD42b+/AV+ and CD31+/CD42b+/AV+, P = 0.048, 0.038, 0.009 and 0.006, respectively], compared to NSTEMI patients (n = 125). Patients who suffered a heart failure during AMI (n = 17) had increased levels of platelet (CD61+)-and monocyte (CD14+)-derived cMPs carrying TF (CD142+) (P<0.0001 and 0.004, respectively). Additionally, NYHA class III (n = 23) patients showed higher levels of CD142+/AV+, CD14+/AV+ and CD14+/CD142+/AV+ cMPs than those in class I/II (P = 0.001, 0.015 and 0.014, respectively). The levels of these cMPs positively correlated with TF-PCA (r≥0.166, P≤0.027, all).
Conclusions:
Platelets and monocytes remain activated in AMI patients treated as per guidelines and release cMPs that discriminate AMI severity. Therefore, TF-MPs, and platelet- and monocyte-MPs may reflect thrombotic burden in AMI patients.
Insights
Circulating microparticles (cMPs) in acute myocardial infarction (AMI) patients indicate disease severity. Platelet- and monocyte-derived TF-MPs correlate with thrombotic burden, offering insights into AMI progression.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Biochemistry
Background:
- Circulating microparticles (cMPs) are vesicles released from activated or injured cells, contributing to intracoronary thrombi.
- Tissue factor (TF)-carrying cMPs are highly procoagulant and implicated in acute myocardial infarction (AMI).
- Mechanisms linking atherosclerotic lesions to different AMI types remain unclear.
Purpose of the Study:
- To investigate the phenotype of cMPs in patients with acute coronary syndromes (ACS).
- To correlate cMP phenotype with AMI severity and thrombotic burden.
Main Methods:
- A cross-sectional study included 200 patients 2-8 weeks post-AMI.
- Flow cytometry measured Annexin V positive (AV+) cMPs from blood and vascular cells.
- Plasma procoagulant activity (TF-PCA) was assessed using a chromogenic assay.
Main Results:
- STEMI patients had higher levels of platelet-derived cMPs compared to NSTEMI patients.
- Patients with heart failure during AMI showed increased platelet- and monocyte-derived TF+ cMPs.
- Elevated TF+ cMPs correlated positively with plasma procoagulant activity.
Conclusions:
- Activated platelets and monocytes release cMPs that can differentiate AMI severity.
- TF-MPs, along with platelet- and monocyte-derived MPs, may serve as indicators of thrombotic burden in AMI.
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