Multicomponent-based analyses of ACS-patient-derived extracellular vesicles as likely tools for tailored...

Area of Science:

• Cardiovascular Medicine
• Biomarker Discovery
• Extracellular Vesicle Research

Background:

• Lack of reliable biomarkers for risk stratification in non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina (UA) leads to unnecessary coronary angiograms (CAGs).
• High-risk patients with NSTEMI/UA require accurate tools to identify those without significant coronary artery disease (CAD).

Purpose of the Study:

• To investigate the utility of circulating extracellular vesicles (EVs) and their microRNA (miRNA) cargo for risk stratification in acute coronary syndrome (ACS) patients.
• To identify novel EV-based biomarkers that can reduce unnecessary CAGs by predicting the absence of critical CAD.

Main Methods:

• Profiling of patient-derived circulating EVs and their miRNA cargo from ACS patients.
• Proteomic analysis to identify differentially enriched proteins in EVs.
• Multivariate analysis to determine predictors of non-critical CAD (NO CAD).

Main Results:

• Enrichment of miR-130a-3p in CD62p+EVs correlated with the absence of non-critical CAD.
• Nine proteins were differentially enriched between patients with and without critical CAD.
• EV-miR-130a-3p, phospholipid transfer protein, and mitochondrial trifunctional enzyme beta subunit predicted NO CAD.
• EV-miR-130a-3p enrichment predicted the absence of multivessel disease.

Conclusions:

• Circulating EV profiling offers a promising strategy for improved risk stratification in ACS patients.
• EV-based biomarkers, particularly EV-miR-130a-3p, can help identify patients unlikely to have significant CAD, potentially avoiding invasive procedures.
• EV profiling can optimize clinical management and reduce healthcare costs associated with unnecessary CAGs.