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Predicting Carotid Artery Disease and Plaque Instability from Cell-derived Microparticles

Wekesa, A.L.; O'Donovan, O.; O'Brien, O.; Phelan, J.P.; Ross, M.D.; Harrison, M.; Wekesa, Anthony L; Cross, K.S.; O'Donovan, Orla; Dowdall, J.F.; O'Brien, O; Doyle, M.; Byrne, L.; Phelan, John P; Ross, Mark D; Landers, R.; Harrison, Michael

Authors

A.L. Wekesa

O. O'Donovan

O. O'Brien

J.P. Phelan

M.D. Ross

M. Harrison

Anthony L Wekesa

K.S. Cross

Orla O'Donovan

J.F. Dowdall

O O'Brien

M. Doyle

L. Byrne

John P Phelan

Mark D Ross

R. Landers

Michael Harrison



Abstract

Objectives
Cell-derived microparticles (MPs) are small plasma membrane-derived vesicles shed from circulating blood cells and may act as novel biomarkers of vascular disease. We investigated the potential of circulating MPs to predict (a) carotid plaque instability and (b) the presence of advanced carotid disease.

Methods
This pilot study recruited carotid disease patients (aged 69.3 ± 1.2 years [mean ± SD], 69% male, 90% symptomatic) undergoing endarterectomy (n = 42) and age- and sex-matched controls (n = 73). Plaques were classified as stable (n = 25) or unstable (n = 16) post surgery using immunohistochemistry. Blood samples were analysed for MP subsets and molecular biomarkers. Odds ratios (OR) are expressed per standard deviation biomarker increase.

Results
Endothelial MP (EMP) subsets, but not any vascular, inflammatory, or proteolytic molecular biomarker, were higher (p < .05) in the unstable than the stable plaque patients. The area under the receiver operator characteristic curve for CD31+41− EMP in discriminating an unstable plaque was 0.73 (0.56–0.90, p < .05). CD31+41− EMP predicted plaque instability (OR = 2.19, 1.08–4.46, p < .05) and remained significant in a multivariable model that included transient ischaemic attack symptom status. Annexin V+ MP, platelet MP (PMP) subsets, and C-reactive protein were higher (p < .05) in cases than controls. Annexin V+ MP (OR = 3.15, 1.49–6.68), soluble vascular cell adhesion molecule-1 (OR = 1.64, 1.03–2.59), and previous smoking history (OR = 3.82, 1.38–10.60) independently (p < .05) predicted the presence of carotid disease in a multivariable model.

Conclusions
EMP may have utility in predicting plaque instability in carotid patients and annexin V+ MPs may predict the presence of advanced carotid disease in aging populations, independent of established biomarkers.

Journal Article Type Article
Acceptance Date Aug 1, 2014
Online Publication Date Sep 10, 2014
Publication Date 2014-11
Deposit Date May 6, 2016
Publicly Available Date Apr 18, 2018
Print ISSN 1078-5884
Electronic ISSN 1532-2165
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 48
Issue 5
Pages 489-495
DOI https://doi.org/10.1016/j.ejvs.2014.08.007
Keywords Microparticles; unstable plaque; biomarker; vascular; carotid endarterectomy;
Public URL http://researchrepository.napier.ac.uk/id/eprint/10027
Publisher URL http://dx.doi.org/10.1016/j.ejvs.2014.08.007
Contract Date Apr 18, 2018

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