title: Circulating CD31+/Annexin V+ microparticles correlate with cardiovascular outcomes.
abstract: OBJECTIVE
  CD31+/Annexin V+ microparticles (MPs) are increased in patients with cardiovascular risk factors and impaired coronary endothelial function. We evaluated whether MPs are an independent marker for cardiovascular events in patients with stable coronary artery disease (CAD).
  
  
  RESULTS
  The number of CD31+/Annexin V+ MP was determined by flow cytometry in 200 patients (age 66.1±10.4 years) and correlated with cardiovascular outcomes. The median follow-up time for major adverse cardiovascular and cerebral event (MACCE)-free survival was 6.1 (6.0/6.4) years. Four patients were lost to follow-up. A first MACCE occurred in 72 patients (37%). Microparticle levels were significantly higher in patients with MACCE compared with patients without event (P=0.004). The prevalence of diabetes (P=0.02) and male gender (P=0.05) was significantly related to the MP level. In multivariate analysis (cardiovascular risk factors, number of diseased vessels, use of angiotensin-converting enzyme-inhibitors and statins), high MP levels were associated with a higher risk for cardiovascular death [Hazard ratio (HR) 4.0, 95% confidence interval (CI) 1.1-14.6; P=0.04], the need for revascularization (HR 2.4, 95% CI 1.3-4.4; P=0.005), and the occurrence of a first MACCE (HR 2.3, 95% CI 1.4-3.8; P=0.001). Inclusion of the MP level into a classical risk factor model substantially increased c-statistics from 0.637 (95% CI: 0.557-0.717) to 0.702 (95% CI: 0.625-0.780) (P=0.03).
  
  
  CONCLUSIONS
  The level of circulating CD31+/Annexin V+ MPs is an independent predictor of cardiovascular events in stable CAD patients and may be useful for risk stratification.
authors.affiliation: Medizinische Klinik und Poliklinik II, Universitätsklinikum Bonn, Sigmund-Freud-Str. 25, 53105, Bonn, Germany.
authors.forename: Jan-Malte
authors.initials: JM
authors.lastname: Sinning
authors.forename: Jan
authors.initials: J
authors.lastname: Losch
authors.forename: Katrin
authors.initials: K
authors.lastname: Walenta
authors.forename: Michael
authors.initials: M
authors.lastname: Böhm
authors.forename: Georg
authors.initials: G
authors.lastname: Nickenig
authors.forename: Nikos
authors.initials: N
authors.lastname: Werner
mesh_terms: D000368:Aged; D017304:Annexin A5 / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D055252:Cell-Derived Microparticles / Q000737:chemistry; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000401:mortality; D016757:Death, Sudden, Cardiac / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000097:blood*; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000401:mortality
chemical_list: D017304:Annexin A5; D015415:Biomarkers; D019408:Platelet Endothelial Cell Adhesion Molecule-1