Effimia Zacharia*, Konstantinos Zacharias, George-Angelo Papamikroulis , Dimitrios Bertsias, Antigoni Miliou, Zoi Pallantza , Nikolaos Papageorgiou and Dimitris Tousoulis Pages 1 - 30 ( 30 )
Background: Despite the recent advances in the treatment of acute coronary syndromes (ACS), patients with ACS are still exposed to an increased risk for adverse cardiovascular events, while their prognosis is difficult to determine. Experimental and clinical studies have shown that cell-derived microparticles (MPs) are associated with the underlying pathophysiological processes that are responsible for atherogenesis and may be causally implicated in the induction of atherothrombosis.
Objective: In the present article we aimed to review the available evidence regarding the predictive role of MPs in patients with ACS.
Results: Evidence suggests that endothelial MPs are associated with future adverse cardiovascular events in patients with ACS. Platelet-derived MPs have been excessively studied, since they have been found to trigger the coagulation cascade; however, their role as predictors of future cardiovascular events remains debatable. The role of red blood cell-derived MPs is more intriguing: they have been proposed as markers of ongoing thrombosis in patients with ACS, while previous studies have shown that they have anti-coagulant properties in healthy individuals. Leukocyte-derived MPs may also have a predictive role, although the studies regarding these are still limited. Last but not least, it was an interesting discovery that circulating MPs can provide information regarding the angiographic lesions in patients with ACS.
Conclusion: The concept of MPs as potential circulating biomarkers in patients with ACS holds much promise. However, large-scale clinical studies are required to evaluate whether the measurement of plasma MPs could be of clinical significance and, thus, dictate a more aggressive treatment strategy in patients with high levels of circulating MPs.
Microparticles, Acute Coronary Syndromes, Endothelium-Derived Microparticles, Platelet-Derived Microparticles, Acute Myocardial Infarction, Unstable Angina, Prognosis, Outcomes
1st Cardiology Department, Hippokration Hospital, University of Athens,Athens, Croydon University Hospital, London, 1st Cardiology Department, Hippokration Hospital, University of Athens,Athens, University of Athens Medical School, Athens, 1st Department of Cardiology, Hippokration Hospital, University of Athens,Athens, 1st Department of Cardiology,Hippokration Hospital, University of Athens,Athens, Barts Heart Centre, St Bartholomew's Hospital, London, 1st Department of Cardiology, Hippokration Hospital, University of Athens