Christersson Christina, Thulin Åsa, Siegbahn Agneta
Christina Christersson, MD, PhD, Department of Medical Sciences, Cardiology, Uppsala University, SE 75185 Uppsala, Sweden, Tel.: +46 18 611 9068, E-mail:
Thromb Haemost. 2017 Jul 26;117(8):1571-1581. doi: 10.1160/TH16-11-0837. Epub 2017 Apr 20.
Microparticles (MPs) are formed from platelets (PMPs), endothelial cells (EMPs) and monocytes (MMPs), and in acute myocardial infarction (MI), there is an increase of MPs in the culprit artery. In this study MPs were evaluated in whole blood in 105 patients with MI at five time-points during a two-year follow-up (FU). Patients with non-ST-elevated MI had higher concentrations of CD41+MPs compared to ST-elevated MI patients (p=0.024). The concentrations of PMPs in whole blood increased during the time period (p<0.001), but no significant change over time was found for EMPs and MMPs. CD62P+MP counts were higher in MI patients with diabetes (p=0.020), and patients with hypertension had increased levels of CD14+MPs (p=0.004). The amount of CD62P+TF+MPs increased significantly during FU (p<0.001). Patients with atherosclerosis in three arterial beds, i. e. coronary, carotid and peripheral arteries, had lower concentrations of CD62P+TF+MPs (p=0.035) and CD144+TF+MPs (p=0.004) compared to patients with atherosclerosis in one or two arterial beds. Higher concentrations of CD62P+MPs early after MI were associated with an increased risk of cardiovascular events during FU, hazard ratio 3.32 (95 %CI1.20-9.31). Only small variations in PMP, EMP and MMP concentrations were found during long-term FU after MI and their levels seem to reflect the underlying cardiovascular disease rather than the acute MI. PMPs expressing P-selectin might be a promising biomarker for predicting future cardiovascular events, but further studies are needed to confirm these results.
微粒（MPs）由血小板（PMPs）、内皮细胞（EMPs）和单核细胞（MMPs）形成，在急性心肌梗死（MI）时，罪犯血管中的MPs会增加。在本研究中，对105例MI患者在两年随访（FU）期间的五个时间点的全血中的MPs进行了评估。与ST段抬高型MI患者相比，非ST段抬高型MI患者的CD41+MPs浓度更高（p=0.024）。全血中PMPs的浓度在该时间段内有所增加（p<0.001），但EMPs和MMPs随时间未发现显著变化。糖尿病MI患者的CD62P+MP计数更高（p=0.020），高血压患者的CD14+MPs水平升高（p=0.004）。CD62P+TF+MPs的数量在随访期间显著增加（p<0.001）。在三个动脉床（即冠状动脉、颈动脉和外周动脉）发生动脉粥样硬化的患者，与在一个或两个动脉床发生动脉粥样硬化的患者相比，CD62P+TF+MPs（p=0.035）和CD144+TF+MPs（p=0.004）的浓度更低。MI后早期较高浓度的CD62P+MPs与随访期间心血管事件风险增加相关，风险比为3.32（95%CI 1.20-9.31）。MI后长期随访期间，PMP、EMP和MMP浓度仅存在微小变化，其水平似乎反映的是潜在的心血管疾病而非急性MI。表达P-选择素的PMPs可能是预测未来心血管事件的一个有前景的生物标志物，但需要进一步研究来证实这些结果。
