Abstract 2897: Elevated Plasma Levels of CD144 positive-Endothelium-Derived Microparticles Predict Future Cardiovascular Events in Patients with Coronary Artery Disease
Background Endothelium-derived microparticles (EMPs) are small membrane-shed vesicles that are generated from endothelial cell surface in response to cellular injury/activation. Recently, we demonstrated the elevated plasma levels of CD144-EMPs, a new plasma marker of endothelial dysfunction, in patients with type-2 diabetes and atherosclerosis. We investigated whether plasma EMPs levels could predict future cardiovascular events in patients with coronary artery disease (CAD).
Methods We measured plasma EMPs levels using anti-CD144 (VE-cadherin) antibody by flowcytometry in consecutive patients with documented CAD (stable CAD; n=120 and acute coronary syndromes; n=30). From 2003, the clinically stable CAD patients were followed up for 24 months with standard medications, including aspirin and statin. The primary end points was a composite of cardiovascular death, nonfatal myocardial infarction, unstable angina, recurrent symptomatic myocardial ischemia requiring sudden re-hospitalization, and stroke.
Results The levels of circulating plasma CD144-EMPs were significantly elevated in patients with acute coronary syndromes compared with stable CAD group [median and interquartile range; 0.653 (0.495–0.815) x106 vs. 1.108 (0.811–1.713) x106/mL, p<0.01]. The mean age was 69.8±9.3 years with 68% males and 30% old myocardial infarction. Mean follow-up duration was 19 months. Kapran-Meier analysis demonstrated a significantly higher probability of cardiovascular events developing in patients with elevated plasma CD144-EMPs levels (log rank test, p=0.008). The higher CD144-EMPs levels (above median) in clinically stable CAD patients significantly predicted future cardiovascular events including age, gender, ejection fraction, traditional CAD risk factors, and C-reactive protein (odds ratio 4.4, confidence interval 1.1 to 25.3; p=0.035).
Conclusion Measurement of plasma levels of CD144-EMPs in clinically stable CAD patients has an independent prognostic value on the occurrence of cardiovascular events. Quantitative evaluation of endothelial dysfunction by CD144-EMPs can be clinically useful for risk assessment of CAD patients who might deserve a more aggressive treatment strategy to improve their prognosis.