OBJECTIVES: This study sought to analyze whether the plasmatic level of leukocyte-derived microparticles (LMP) is associated with unstable plaques in patients with high-grade carotid stenosis. BACKGROUND: Preventive carotid surgery in asymptomatic patients is currently debated given the improvement of medical therapy. Therefore, noninvasive biomarkers that can predict plaque instability are needed. The LMPs, originating from activated or apoptotic leukocytes, are the major microparticle (MP) subset in human carotid plaque extracts. METHODS: Forty-two patients with >70% carotid stenosis were enrolled. Using a new standardized high-sensitivity flow cytometry assay, LMPs were measured before thromboendarterectomy. The removed plaques were characterized as stable or unstable using histological analysis according to the American Heart Association criteria. The LMP levels were analyzed according to the plaque morphology. RESULTS: The median LMP levels were significantly higher in patients with unstable plaque (n = 28; CD11bCD66b+ MP/μl 240 [25th to 75th percentile: 147 to 394], and CD15+ MP/μl 147 [60 to 335]) compared to patients with stable plaque (16 [0 to 234] and 55 [36 to 157]; p < 0.001 and p < 0.01, respectively). The increase in LMP levels was also significant when considering only the group of asymptomatic patients with unstable plaque (n = 10; CD11bCD66b+ MP/μl 199 [153 to 410] and CD15+ MP/μl 78 [56 to 258] compared with patients with stable plaque (n = 14; 20 [0 to 251] and 55 [34 to 102]; p < 0.05 and p < 0.05, respectively). After logistic regression, the neurologic symptoms (odds ratio: 48.7, 95% confidence interval: 3.0 to 788, p < 0.01) and the level of CD11bCD66b+ MPs (odds ratio: 24.4, 95% confidence interval: 2.4 to 245, p < 0.01) independently predicted plaque instability. CONCLUSIONS: LMP constitute a promising biomarker associated with plaque vulnerability in patients with high-grade carotid stenosis. These data provide clues for identifying asymptomatic subjects that are most at risk of neurologic events.
OBJECTIVES: This study sought to analyze whether the plasmatic level of leukocyte-derived microparticles (LMP) is associated with unstable plaques in patients with high-grade carotid stenosis. BACKGROUND: Preventive carotid surgery in asymptomatic patients is currently debated given the improvement of medical therapy. Therefore, noninvasive biomarkers that can predict plaque instability are needed. The LMPs, originating from activated or apoptotic leukocytes, are the major microparticle (MP) subset in human carotid plaque extracts. METHODS: Forty-two patients with >70% carotid stenosis were enrolled. Using a new standardized high-sensitivity flow cytometry assay, LMPs were measured before thromboendarterectomy. The removed plaques were characterized as stable or unstable using histological analysis according to the American Heart Association criteria. The LMP levels were analyzed according to the plaque morphology. RESULTS: The median LMP levels were significantly higher in patients with unstable plaque (n = 28; CD11bCD66b+ MP/μl 240 [25th to 75th percentile: 147 to 394], and CD15+ MP/μl 147 [60 to 335]) compared to patients with stable plaque (16 [0 to 234] and 55 [36 to 157]; p < 0.001 and p < 0.01, respectively). The increase in LMP levels was also significant when considering only the group of asymptomatic patients with unstable plaque (n = 10; CD11bCD66b+ MP/μl 199 [153 to 410] and CD15+ MP/μl 78 [56 to 258] compared with patients with stable plaque (n = 14; 20 [0 to 251] and 55 [34 to 102]; p < 0.05 and p < 0.05, respectively). After logistic regression, the neurologic symptoms (odds ratio: 48.7, 95% confidence interval: 3.0 to 788, p < 0.01) and the level of CD11bCD66b+ MPs (odds ratio: 24.4, 95% confidence interval: 2.4 to 245, p < 0.01) independently predicted plaque instability. CONCLUSIONS:LMP constitute a promising biomarker associated with plaque vulnerability in patients with high-grade carotid stenosis. These data provide clues for identifying asymptomatic subjects that are most at risk of neurologic events.
Authors: Dae-Kyum Kim; Jaewook Lee; Sae Rom Kim; Dong-Sic Choi; Yae Jin Yoon; Ji Hyun Kim; Gyeongyun Go; Dinh Nhung; Kahye Hong; Su Chul Jang; Si-Hyun Kim; Kyong-Su Park; Oh Youn Kim; Hyun Taek Park; Ji Hye Seo; Elena Aikawa; Monika Baj-Krzyworzeka; Bas W M van Balkom; Mattias Belting; Lionel Blanc; Vincent Bond; Antonella Bongiovanni; Francesc E Borràs; Luc Buée; Edit I Buzás; Lesley Cheng; Aled Clayton; Emanuele Cocucci; Charles S Dela Cruz; Dominic M Desiderio; Dolores Di Vizio; Karin Ekström; Juan M Falcon-Perez; Chris Gardiner; Bernd Giebel; David W Greening; Julia Christina Gross; Dwijendra Gupta; An Hendrix; Andrew F Hill; Michelle M Hill; Esther Nolte-'t Hoen; Do Won Hwang; Jameel Inal; Medicharla V Jagannadham; Muthuvel Jayachandran; Young-Koo Jee; Malene Jørgensen; Kwang Pyo Kim; Yoon-Keun Kim; Thomas Kislinger; Cecilia Lässer; Dong Soo Lee; Hakmo Lee; Johannes van Leeuwen; Thomas Lener; Ming-Lin Liu; Jan Lötvall; Antonio Marcilla; Suresh Mathivanan; Andreas Möller; Jess Morhayim; François Mullier; Irina Nazarenko; Rienk Nieuwland; Diana N Nunes; Ken Pang; Jaesung Park; Tushar Patel; Gabriella Pocsfalvi; Hernando Del Portillo; Ulrich Putz; Marcel I Ramirez; Marcio L Rodrigues; Tae-Young Roh; Felix Royo; Susmita Sahoo; Raymond Schiffelers; Shivani Sharma; Pia Siljander; Richard J Simpson; Carolina Soekmadji; Philip Stahl; Allan Stensballe; Ewa Stępień; Hidetoshi Tahara; Arne Trummer; Hadi Valadi; Laura J Vella; Sun Nyunt Wai; Kenneth Witwer; María Yáñez-Mó; Hyewon Youn; Reinhard Zeidler; Yong Song Gho Journal: Bioinformatics Date: 2014-11-10 Impact factor: 6.937