title: Microparticles and their role in coronary artery disease.
abstract: Despite significant advances in prevention, medical and interventional management, coronary artery disease (CAD) remains the leading cause of death worldwide. Although the number of people being diagnosed with CAD has plateaued in the western world, it is projected to increase significantly in the developing world reaching epidemic proportions, particularly in South Asia. To better stratify the risk of developing and suffering a cardiovascular event due to CAD, not only plasma biomarkers relating to disease burden but also disease activity in CAD are needed; this will allow targeting of appropriate management to high-risk patients for acute events. Over the last twenty years, data have emerged showing the role of sub-micron vesicles called microparticles (MPs) in the pathogenesis of formation and evolution of atherosclerotic plaques causing either stable angina (SA) or acute coronary syndromes (ACS). Herein we provide an overview of our current knowledge of MP formation, composition and possible mechanisms through which they could be contributing to CAD. We also reviewed currently available methods and their limitations in quantifying MPs and in determining their functional aspects. Role of various treatments ranging from dietary substitutes to oral medicines and intravenous medications to mechanistic procedures such as hemofiltration are elaborated. Although evidence implicating the role of MPs in CAD are mounting large scale prospective studies are still lacking and are the need of the hour prior to establishing the use of MPs as biomarkers for the early detection of CAD and its progression.
authors.affiliation: Department of Cardiology Royal Free Hospital Pond Street, London, Uk NW3 2QG; UCL Institute of Cardiovascular Science Gower Street London WC1E 6BT.
authors.forename: Sudheer
authors.initials: S
authors.lastname: Koganti
authors.affiliation: UCL Great Ormond Street Institute of Child Health 30 Guilford Street London WC1N 1EH.
authors.forename: Despina
authors.initials: D
authors.lastname: Eleftheriou
authors.affiliation: UCL Great Ormond Street Institute of Child Health 30 Guilford Street London WC1N 1EH.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Brogan
authors.affiliation: Department of Cardiology Royal Free Hospital Pond Street, London, Uk NW3 2QG; UCL Institute of Cardiovascular Science Gower Street London WC1E 6BT.
authors.forename: Tushar
authors.initials: T
authors.lastname: Kotecha
authors.affiliation: UCL Great Ormond Street Institute of Child Health 30 Guilford Street London WC1N 1EH.
authors.forename: Ying
authors.initials: Y
authors.lastname: Hong
authors.affiliation: Department of Cardiology Royal Free Hospital Pond Street, London, Uk NW3 2QG; UCL Institute of Cardiovascular Science Gower Street London WC1E 6BT. Electronic address: roby.rakhit@nhs.net.
authors.forename: Roby D
authors.initials: RD
authors.lastname: Rakhit
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D055252:Cell-Derived Microparticles / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000209:etiology / Q000378:metabolism*; D006801:Humans; D058226:Plaque, Atherosclerotic / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism
chemical_list: D015415:Biomarkers
keywords: Acute coronary syndrome; Biomarker; Coronary artery disease; Microparticles