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Increased concentrations of platelet- and endothelial-derived microparticles in patients with myocardial infarction

Josefin Mörtberg1, Kristina Lundwall2, Fariborz Mobarrez3

  • 1Division of Nephrology, Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden. josefin.mortberg@sll.se.

BMC Nephrology
|March 3, 2019
PubMed
Abstract

Insights

Patients with chronic kidney disease (CKD) and acute myocardial infarction (AMI) show elevated platelet-rich microparticles (PMPs) and endothelial microparticles (EMPs). These findings suggest increased platelet activation and endothelial dysfunction in CKD patients, even with antiplatelet therapy.

Area of Science:

  • Cardiovascular Research
  • Nephrology
  • Hematology

Background:

  • Patients with chronic kidney disease (CKD) face a heightened risk of recurrent thrombotic events post-acute myocardial infarction (AMI).
  • Microparticles (MPs), including platelet-derived (PMPs) and endothelial-derived (EMPs), are biomarkers of cellular activation and dysfunction.
  • Elevated MPs are observed after AMI, potentially mediating biological effects.

Purpose of the Study:

  • To investigate whether AMI patients with CKD exhibit higher levels of PMPs and EMPs compared to non-CKD patients.
  • To assess the impact of CKD severity on PMP and EMP levels in AMI patients undergoing antithrombotic treatment.

Main Methods:

  • A descriptive study involving 47 AMI patients stratified by renal function: normal (H), moderate CKD (CKD3), and severe CKD (CKD4-5).
  • Blood samples were analyzed using flow cytometry to quantify PMPs (CD41+) and EMPs (CD62E+).
  • Expression of platelet activation markers (CD62P, CD40 ligand) on PMPs was also assessed.

Main Results:

  • Severe CKD (CKD4-5) patients had significantly higher PMPs expressing CD40 ligand compared to normal (H) and moderate CKD (CKD3) groups (p < 0.0001).
  • PMPs expressing P-selectin were elevated in severe CKD (CKD4-5) versus normal (H) but not moderate CKD (CKD3).
  • EMPs were significantly higher in severe CKD (CKD4-5) compared to both normal (H) (p < 0.0001) and moderate CKD (CKD3) (p < 0.002) groups.

Conclusions:

  • AMI patients with CKD demonstrate further elevation of PMPs and EMPs, indicating heightened platelet activation and endothelial dysfunction.
  • These findings persist despite concurrent antiplatelet therapy, highlighting the prothrombotic state associated with CKD in AMI patients.
Keywords:
Acute coronary syndromeChronic kidney diseaseHaemostasisRenal dysfunctionRenal failureThrombosis

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