Circulating endothelial and platelet derived microparticles reflect the size of myocardium at risk in patients with ST-elevation myocardial infarction

doi:10.1016/j.atherosclerosis.2011.12.025

Atherosclerosis

Volume 221, Issue 1, March 2012, Pages 226-231

https://doi.org/10.1016/j.atherosclerosis.2011.12.025 Get rights and content

Abstract

Objectives

Microparticles (MP) are small membrane vesicles, released from activated, damaged and apoptotic endothelial cells (EMP) or platelets (PMP) that may actively modulate inflammation, coagulation and vascular function. We tested the hypothesis that the number of circulating EMP or PMP in acute myocardial infarction correlates with the myocardium at risk (MaR) and infarct size (IS).

Methods

EMP were quantified in plasma samples of 36 patients (age: 63 ± 10 years) with first time ST-elevation myocardial infarction (STEMI) using flow cytometry. EMP were defined as CD31⁺/CD42⁻ MP and CD144⁺ MP and PMP as CD31⁺/CD42⁺ MP. MaR and IS was determined by cardiovascular magnetic resonance imaging one week after the index event.

Results

Plasma levels of CD31⁺/CD42⁻ EMP were 251.0 ± 178.8/μl and CD144⁺ 106.3 ± 33.7/μl. PMP levels were 579.2 ± 631.8/μl. MaR was 31.0 ± 11.2% of the left ventricle and IS was 11.4 ± 7.1% of the left ventricle. Patients with STEMI in the left anterior descending artery had higher levels of CD31⁺/CD42⁻ EMP and PMP than those with other infarct-related arteries (p < 0.05). The numbers of CD31⁺/CD42⁻ EMP and PMP correlated to MaR, but not to IS.

Conclusions

Circulating EMP and PMP correlate to the size of MaR in patients with STEMI suggesting that they reflect the severity of the endothelial injury and platelet activation during myocardial ischemia.

Highlights

► Microparticles are small membrane vesicles, released from activated, damaged and apoptotic cells. ► Endothelial (EMP) and platelet (PMP) microparticles were quantified in patients with first time ST-elevation myocardial infarction (STEMI). ► The numbers of EMP and PMP correlated to the myocardium at risk, but not to infarct size assessed by cardiac magnetic resonance.

Section snippets

Study subjects

Following written informed consent 36 consecutive patients with STEMI planned for primary percutaneous coronary intervention (PCI) were enrolled. The study complies with the Declaration of Helsinki. All patients were admitted for primary PCI due to a first time STEMI. Inclusion criteria were: chest pain ≥30 min and ≤6 h duration, ST-elevation in at least two contiguous ECG leads or left bundle branch block and a complete coronary occlusion (TIMI flow grade 0) of the infarct-related artery at the

Results

The baseline characteristics are summarized in Table 1. All patient characteristics related to the PCI procedure are presented in Table 2. Plasma levels of CD31⁺/CD42⁻ EMP were 251.0 ± 178.8/μl and CD144⁺ 106.3 ± 33.7/μl. Platelet CD31⁺/CD42⁺ MP were 579.2 ± 631.8/μl. MaR was 31.0 ± 11.2% and IS was 11.1 ± 7.6% of the left ventricle, respectively. Details regarding the number of EMP and PMP as well as CMR data are presented in Table 3.

CD31⁺CD42⁻, CD144⁺ EMP and CD31⁺CD42⁺ PMP counts did not correlate to

Discussion

The present study demonstrates that circulating CD31⁺/CD42⁻ EMP and CD31⁺/CD42⁺ PMP correlate to the size of MaR in patients with STEMI. This observation suggests that the number of CD31⁺/CD42⁻ EMP reflect the coronary endothelial region affected by ischemia. Furthermore, it supports the view that PMP are a marker of ongoing thrombosis adding to the body of knowledge that circulating levels correlate to the extent of the ischemic and thrombotic burden.

It is well established that apoptotic or

Disclosure

None.

Acknowledgements

We thank Marita Wallin and Kerstin Höglund for their excellent technical assistance. Supported by the Swedish Heart and Lung Foundation, the Swedish Research Council (10857), Karolinska Institutet/Stockholm County Council Strategic Cardiovascular Programme, Gustav V and Queen Victoria Foundation, and the Novo Nordisk Foundation.

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Circulating endothelial and platelet derived microparticles reflect the size of myocardium at risk in patients with ST-elevation myocardial infarction

Abstract

Objectives

Methods

Results

Conclusions

Highlights

Section snippets

Study subjects

Results

Discussion

Disclosure

Acknowledgements

Am Heart J

Am J Cardiol

Eur J Intern Med

J Am Coll Cardiol

J Card Fail

Am Heart J

J Cardiovasc Magn Reson

Thromb Res

Diabetes Metab

Blood

J Thromb Haemost

Am J Pathol

Thromb Res

Int J Cardiol

Atherosclerosis

J Heart Lung Transplant

Am J Hypertens

Eur J Pharmacol

Thromb Res

Atherosclerosis

J Am Coll Cardiol

Roles of dietary inorganic nitrate in cardiovascular health and disease

Cardiovasc Res

Arginase inhibition mediates cardioprotection during ischaemia-reperfusion

Cardiovasc Res