title: Red blood cell and platelet microparticles in myocardial infarction patients treated with primary angioplasty.
abstract: BACKGROUND
  Red blood cell and platelet microparticles (RBCm and PLTm, respectively) have drawn research attention as to their potential prothrombotic and vasoconstrictive effects in experimental settings. However, the relevance of circulating microparticles in clinical settings is largely undetermined.
  
  
  METHODS
  Circulating microparticles were quantified with a flow cytometric method in blood samples from consecutive STEMI patients after primary PCI. A matched cohort of healthy volunteers was used to derive reference values for comparison. STEMI patients were followed for 6 months for a composite clinical endpoint.
  
  
  RESULTS
  Fifty-one STEMI patients (age 59.8 ± 8.8 years) and 50 controls (age 56.2 ± 9.2 years; p=0.155) were enrolled. RBCm concentration was 18,198 ± 6062/μl in the reference cohort versus 33,740 ± 21,169/μl in STEMI patients (p<0.001). RBCm count was not correlated to total RBCs (standardized beta 0.018; p=0.861). PLTm did not differ between groups (17,529 ± 16,292/μl in STEMI patients versus 14,372 ± 6211/μl in controls; p=0.203). RBCm c-statistic was 0.832 (95% confidence interval 0.720 to 0.944), while PLTm prognostic value was not statistically significant (c-statistic 0.614, 95% confidence interval 0.444 to 0.784). In the multivariate analysis, RBCm concentration was independently associated with the occurrence of the clinical endpoint, after adjustment for age, ejection fraction, serum creatinine and presence of diabetes (adjusted p=0.034).
  
  
  CONCLUSIONS
  The present study demonstrates for the first time that erythrocyte microparticles are elevated in patients with STEMI treated with primary PCI, with levels approximately double those measured in a reference population of healthy volunteers, and their concentrations appear to be positively associated with adverse clinical events.
authors: Cardiac Catheterization Laboratory, Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece; Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT, USA. Electronic address: ggiann@med.uoa.gr.
authors: Georgios
authors: G
authors: Giannopoulos
authors: Flow Cytometry Laboratory, Department of Immunology, Athens General Hospital "G. Gennimatas", Athens, Greece.
authors: Georgios
authors: G
authors: Oudatzis
authors: Flow Cytometry Laboratory, Department of Immunology, Athens General Hospital "G. Gennimatas", Athens, Greece.
authors: Georgios
authors: G
authors: Paterakis
authors: 1st Department of Cardiology, University of Athens Medical School, Athens, Greece.
authors: Andreas
authors: A
authors: Synetos
authors: Cardiac Catheterization Laboratory, Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece.
authors: Eleni
authors: E
authors: Tampaki
authors: Cardiac Catheterization Laboratory, Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece.
authors: Georgios
authors: G
authors: Bouras
authors: Department of Cardiology, University of Patras Medical School, Patras, Greece.
authors: George
authors: G
authors: Hahalis
authors: Department of Cardiology, University of Patras Medical School, Patras, Greece.
authors: Dimitrios
authors: D
authors: Alexopoulos
authors: 1st Department of Cardiology, University of Athens Medical School, Athens, Greece.
authors: Dimitrios
authors: D
authors: Tousoulis
authors: Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT, USA.
authors: Michael W
authors: MW
authors: Cleman
authors: 1st Department of Cardiology, University of Athens Medical School, Athens, Greece.
authors: Christodoulos
authors: C
authors: Stefanadis
authors: Cardiac Catheterization Laboratory, Department of Cardiology, Athens General Hospital "G. Gennimatas", Athens, Greece; Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT, USA.
authors: Spyridon
authors: S
authors: Deftereos
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001792:Blood Platelets / Q000378:metabolism*; D055252:Cell-Derived Microparticles / Q000378:metabolism*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004912:Erythrocytes / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000628:therapy*; D016896:Treatment Outcome
keywords: Erythrocyte; Flow cytometry; Microparticles; Myocardial infarction; Platelet