PLATELET-DERIVED-MICROPARTICLES IN PATIENTS WITH ISCHEMIC HEART DISEASE

Abstract

Current studies prove that the occlusive coronary artery disease (ischaemic heart disease) is the commonest cause of mortality in most developing countries. CAD includes a widely variable scope of disease severity, ranging from CSA, UA and up to both types of AMI, which are STEMI, and NSTEMI. There is a proved need for a multi-marker approach/ protocol in order to accurately diagnose, and hence manage patients with IHD, presented to the emergency room as ACS, especially at very early presentation, where present cardiac markers are neither sufficiently sensitive nor specific. So, a novel conjunct biomarker, which is the flow cytometric PMPs assay could be used. As it also could help in monitoring the drug dose escalation and hence responsiveness, this could lead eventually to lower hospitalization rates, avoid faulty discharging patients who have an ACS, with a less need to more sophisticated, expensive, and time consuming other prognostic modalities. Thrombosis is a major cause of ACS, where platelets and PMPs play a fundamental role. It was well proved that platelets and CD61-positive MPs, i.e. PMPs, especially those who are GP IIb/IIIa-positive (CD41-positive- PMPs) modulate both initiation and propagation of this forming thrombus and the inflammatory component of atheromatous lesions in ACS. The ACS severity is strongly correlated to the percent of GP IIb/IIIa-positive surface expression, reflecting PMPs activity, whose expression is best measured by flow cytometry. So, PMPs became one of the key factors for disease progression, so they become a prime target for an effective treatment.