Abstract

Plasma Extracellular Vesicles as a Biomarker Source for Cardiovascular Disease

Dominique PV de Kleijn, Professor Experimental Vascular Surgery; Professor Netherlands Heart Institute, University Medical Center Utrecht

Cardiovascular Disease (CVD) is with cardiovascular events of Ischemic Heart Disease (IHD) and Stroke, the number 1 and 2 cause of death in the world and expect to increase especially in Asia. We use protein signatures measured in 3 different subsets of plasma extracellular vesicle (EV) as an accurate source for early diagnosis and prediction of cardiovascular events like IHD and Stroke.

The diagnosis IHD is challenging, as many patients present with atypical symptoms. It is known that women have a different symptom sensation than men. Troponins are the main diagnostic tool for detection of MI. Blood biomarkers for stable angina (SA) and unstable angina (UA), however, are not available. These diagnoses frequently require hospital visits/admissions for time-consuming and costly (non)invasive tests. Using a simplified method that is suitable for automation and microfluidics to isolate the plasma EV subfractions in 25 ul plasma, we now validated our data in a large case control study (150 cases vs 300 controls) that showed that  EV subfractions can diagnose accurately SA in a drop of blood. Next to this, using another signature in plasma EV subfractions for patient that undergo a carotid endatherectomy (CEA) we could accurately determine which patient will get a second cardiovascular event (myocardial infarction, stroke or death) or not within 3 years after CEA.

Plasma EV subfractions  are a very valuable biomarker source for the diagnosis and prognosis of cardiovascular disease.