Abstract

Extracellular Vesicles For Early Diagnosis of Stable Angina in a General Practitioner Environment

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.

Stable Coronary Artery Disease (SCAD) or Stable Angina (SA) is one of the entities of IHD but in contrast to hsTroponins for myocardial infarction, there is no bloodmarker for quick and easy diagnosis.
SA is a very common disease (10-14% in the age group of 65-84 years) and a serious pathology resulting in a 4-6 times higher change of cardiovascular events like myocardial infarction. SA diagnosis is challenging, as many patients present with atypical symptoms with women have a different symptom sensation than men. This results in that 90% of women with chest pain suspected for SA are referred to the hospital by the GP do not have SA.
A simple SA early diagnosis blood test is expected to allow GPs to improve their assessment and decisons to refer or not to refer a patient to a cardiologist, reducing care costs and efficiency of care trajectories.
We have now a validated protein signature measured  in subsets of plasma extracellular vesicle (EV) that can accurately diagnose SA in women using 25 ul plasma. We simplified and validated this EV-based blood assay and will now develop a microfluidic device to isolate plasma EV subsets and determine EV biomarker levels that will make early diagnosis of SA in the GP environment possible.
Such a microfluidic device will also be very useful in other POC applications using EV subsets in diagnosis and prognosis of cardiovascular disease in GP or ambulance.