Endothelial microparticles correlate with high-risk angiographic lesions in acute coronary syndromes

Leon Bernal-Mizrachi, Wenche Jy, Christian Fierro, Rick Macdonough, Hermes A. Velazques, Joshua Purow, Joaquin J Jimenez, Lawrence L. Horstman, Alexandre Ferreira, Eduardo De Marchena, Yeon Ahn

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Abstract

Background: Endothelial Microparticles (EMP) are small fragments of endothelial cell membrane shed during apoptosis or activation. Our group has previously reported elevations of EMP in patients with coronary artery disease (CAD), thrombotic thrombocytopenic purpura (TTP), pre-eclampsia, multiple sclerosis (MS), and severe hypertension (HTN). In the present study, we evaluate the possible relationship between EMP levels and the angiographic severity and characteristics of coronary obstructive lesions. Methods: We studied a total of 43 patients undergoing coronary angiography. Fifteen had presented with acute myocardial infarction (MI), 20 with unstable anginas (UA), 5 with stable angina (SA) and 3 with congestive heart failure. Coronary angiography was reviewed and coronary lesions were classified using the Ambrose classification. Coronary stenoses were classified as high and low risk. High-risk included lesions with eccentric appearance (type II), presence of thrombi, or multiple irregularities. Low-risk lesions were defined as concentric or type I. Lesions were also analyzed by degree of stenosis and history of acute coronary syndrome (ACS). EMP in plasma was assayed by flow cytometry. Results: EMP in eccentric type II or multiple irregular lesions (high-risk) were 2.5-fold higher than in type I or concentric (low-risk) lesions, p<0.05. Lesions with thrombi had three-fold higher EMP than those without (p=0.05). Mild stenosis (>20%-<45%) had three-fold higher EMP than more severe (>45%), and five-fold higher than those without stenosis (p<0.01). Among patients with type II lesions, those with first ACS episode had four-fold higher EMP levels than those with recurrent ACS (p<0.01). Conclusion: High EMP was associated with high-risk angiographic lesions including eccentric type II, multiple irregular, and lesions with thrombi. Mild to moderate stenosis was associated with higher EMP levels than severe stenosis. EMP may be a useful marker in detecting endothelial injury and risk of ACS as defined by angiography.

Original languageEnglish
Pages (from-to)439-446
Number of pages8
JournalInternational Journal of Cardiology
Volume97
Issue number3
DOIs
StatePublished - Dec 1 2004

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Acute Coronary Syndrome
Pathologic Constriction
Coronary Angiography
Thrombosis
Thrombotic Thrombocytopenic Purpura
Stable Angina
Coronary Stenosis
Pre-Eclampsia
Multiple Sclerosis
Coronary Artery Disease
Angiography
Flow Cytometry
Endothelial Cells
Heart Failure
Myocardial Infarction
Cell Membrane
Apoptosis
Hypertension
Wounds and Injuries

Keywords

  • Acute coronary syndromes
  • Endothelial injury
  • Endothelial microparticles
  • High-risk angiographic lesions
  • Stenotic lesions

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Endothelial microparticles correlate with high-risk angiographic lesions in acute coronary syndromes. / Bernal-Mizrachi, Leon; Jy, Wenche; Fierro, Christian; Macdonough, Rick; Velazques, Hermes A.; Purow, Joshua; Jimenez, Joaquin J; Horstman, Lawrence L.; Ferreira, Alexandre; De Marchena, Eduardo; Ahn, Yeon.

In: International Journal of Cardiology, Vol. 97, No. 3, 01.12.2004, p. 439-446.

Research output: Contribution to journalArticle

Bernal-Mizrachi, L, Jy, W, Fierro, C, Macdonough, R, Velazques, HA, Purow, J, Jimenez, JJ, Horstman, LL, Ferreira, A, De Marchena, E & Ahn, Y 2004, 'Endothelial microparticles correlate with high-risk angiographic lesions in acute coronary syndromes', International Journal of Cardiology, vol. 97, no. 3, pp. 439-446. https://doi.org/10.1016/j.ijcard.2003.10.029
Bernal-Mizrachi, Leon ; Jy, Wenche ; Fierro, Christian ; Macdonough, Rick ; Velazques, Hermes A. ; Purow, Joshua ; Jimenez, Joaquin J ; Horstman, Lawrence L. ; Ferreira, Alexandre ; De Marchena, Eduardo ; Ahn, Yeon. / Endothelial microparticles correlate with high-risk angiographic lesions in acute coronary syndromes. In: International Journal of Cardiology. 2004 ; Vol. 97, No. 3. pp. 439-446.
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abstract = "Background: Endothelial Microparticles (EMP) are small fragments of endothelial cell membrane shed during apoptosis or activation. Our group has previously reported elevations of EMP in patients with coronary artery disease (CAD), thrombotic thrombocytopenic purpura (TTP), pre-eclampsia, multiple sclerosis (MS), and severe hypertension (HTN). In the present study, we evaluate the possible relationship between EMP levels and the angiographic severity and characteristics of coronary obstructive lesions. Methods: We studied a total of 43 patients undergoing coronary angiography. Fifteen had presented with acute myocardial infarction (MI), 20 with unstable anginas (UA), 5 with stable angina (SA) and 3 with congestive heart failure. Coronary angiography was reviewed and coronary lesions were classified using the Ambrose classification. Coronary stenoses were classified as high and low risk. High-risk included lesions with eccentric appearance (type II), presence of thrombi, or multiple irregularities. Low-risk lesions were defined as concentric or type I. Lesions were also analyzed by degree of stenosis and history of acute coronary syndrome (ACS). EMP in plasma was assayed by flow cytometry. Results: EMP in eccentric type II or multiple irregular lesions (high-risk) were 2.5-fold higher than in type I or concentric (low-risk) lesions, p<0.05. Lesions with thrombi had three-fold higher EMP than those without (p=0.05). Mild stenosis (>20{\%}-<45{\%}) had three-fold higher EMP than more severe (>45{\%}), and five-fold higher than those without stenosis (p<0.01). Among patients with type II lesions, those with first ACS episode had four-fold higher EMP levels than those with recurrent ACS (p<0.01). Conclusion: High EMP was associated with high-risk angiographic lesions including eccentric type II, multiple irregular, and lesions with thrombi. Mild to moderate stenosis was associated with higher EMP levels than severe stenosis. EMP may be a useful marker in detecting endothelial injury and risk of ACS as defined by angiography.",
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author = "Leon Bernal-Mizrachi and Wenche Jy and Christian Fierro and Rick Macdonough and Velazques, {Hermes A.} and Joshua Purow and Jimenez, {Joaquin J} and Horstman, {Lawrence L.} and Alexandre Ferreira and {De Marchena}, Eduardo and Yeon Ahn",
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AU - Bernal-Mizrachi, Leon

AU - Jy, Wenche

AU - Fierro, Christian

AU - Macdonough, Rick

AU - Velazques, Hermes A.

AU - Purow, Joshua

AU - Jimenez, Joaquin J

AU - Horstman, Lawrence L.

AU - Ferreira, Alexandre

AU - De Marchena, Eduardo

AU - Ahn, Yeon

PY - 2004/12/1

Y1 - 2004/12/1

N2 - Background: Endothelial Microparticles (EMP) are small fragments of endothelial cell membrane shed during apoptosis or activation. Our group has previously reported elevations of EMP in patients with coronary artery disease (CAD), thrombotic thrombocytopenic purpura (TTP), pre-eclampsia, multiple sclerosis (MS), and severe hypertension (HTN). In the present study, we evaluate the possible relationship between EMP levels and the angiographic severity and characteristics of coronary obstructive lesions. Methods: We studied a total of 43 patients undergoing coronary angiography. Fifteen had presented with acute myocardial infarction (MI), 20 with unstable anginas (UA), 5 with stable angina (SA) and 3 with congestive heart failure. Coronary angiography was reviewed and coronary lesions were classified using the Ambrose classification. Coronary stenoses were classified as high and low risk. High-risk included lesions with eccentric appearance (type II), presence of thrombi, or multiple irregularities. Low-risk lesions were defined as concentric or type I. Lesions were also analyzed by degree of stenosis and history of acute coronary syndrome (ACS). EMP in plasma was assayed by flow cytometry. Results: EMP in eccentric type II or multiple irregular lesions (high-risk) were 2.5-fold higher than in type I or concentric (low-risk) lesions, p<0.05. Lesions with thrombi had three-fold higher EMP than those without (p=0.05). Mild stenosis (>20%-<45%) had three-fold higher EMP than more severe (>45%), and five-fold higher than those without stenosis (p<0.01). Among patients with type II lesions, those with first ACS episode had four-fold higher EMP levels than those with recurrent ACS (p<0.01). Conclusion: High EMP was associated with high-risk angiographic lesions including eccentric type II, multiple irregular, and lesions with thrombi. Mild to moderate stenosis was associated with higher EMP levels than severe stenosis. EMP may be a useful marker in detecting endothelial injury and risk of ACS as defined by angiography.

AB - Background: Endothelial Microparticles (EMP) are small fragments of endothelial cell membrane shed during apoptosis or activation. Our group has previously reported elevations of EMP in patients with coronary artery disease (CAD), thrombotic thrombocytopenic purpura (TTP), pre-eclampsia, multiple sclerosis (MS), and severe hypertension (HTN). In the present study, we evaluate the possible relationship between EMP levels and the angiographic severity and characteristics of coronary obstructive lesions. Methods: We studied a total of 43 patients undergoing coronary angiography. Fifteen had presented with acute myocardial infarction (MI), 20 with unstable anginas (UA), 5 with stable angina (SA) and 3 with congestive heart failure. Coronary angiography was reviewed and coronary lesions were classified using the Ambrose classification. Coronary stenoses were classified as high and low risk. High-risk included lesions with eccentric appearance (type II), presence of thrombi, or multiple irregularities. Low-risk lesions were defined as concentric or type I. Lesions were also analyzed by degree of stenosis and history of acute coronary syndrome (ACS). EMP in plasma was assayed by flow cytometry. Results: EMP in eccentric type II or multiple irregular lesions (high-risk) were 2.5-fold higher than in type I or concentric (low-risk) lesions, p<0.05. Lesions with thrombi had three-fold higher EMP than those without (p=0.05). Mild stenosis (>20%-<45%) had three-fold higher EMP than more severe (>45%), and five-fold higher than those without stenosis (p<0.01). Among patients with type II lesions, those with first ACS episode had four-fold higher EMP levels than those with recurrent ACS (p<0.01). Conclusion: High EMP was associated with high-risk angiographic lesions including eccentric type II, multiple irregular, and lesions with thrombi. Mild to moderate stenosis was associated with higher EMP levels than severe stenosis. EMP may be a useful marker in detecting endothelial injury and risk of ACS as defined by angiography.

KW - Acute coronary syndromes

KW - Endothelial injury

KW - Endothelial microparticles

KW - High-risk angiographic lesions

KW - Stenotic lesions

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