LAUSR

Objective: Circulating microvesicles (MVs) emerge as biomarkers of endothelial injury and thrombosis, primarily in cardiovascular (CV) disease. Therefore, we measured endothelial (EMVs), platelet (PMVs) and erythrocyte MVs (RMVs) in patients with various degree of CV burden. We then sought to compare them to coronary artery disease (CAD), as positive, and to healthy subjects, free from CV risk factors, as negative controls. We finally identified independent predictors of MVs. Design and method: We enrolled consecutive patients from our Cardiology, Hypertension, Diabetic, Rheumatic, and Nephrology Outpatient Units with available MVs measurements. Central blood pressure (BP) was measured by either applanation tonometry or Mobil-O-graph device, while MVs by a previously described, standardized flow cytometry protocol. Results: We studied 369 participants with increased CV risk: 63 with CAD equivalent (47 diabetes mellitus type II/DM and 16 end-stage renal disease), 92 with chronic inflammatory disorders and 73 with essential hypertension/EH. We further included 53 subjects with CAD as positive and 87 otherwise healthy as negative controls. All MVs were lower in patients with increased CV risk as compared to positive controls (p < 0.001 for all). In addition, PMVs (p = 0.045) and EMVs (p = 0.028) were increased in patients with increased CV risk as compared to negative controls. Between patients with increased CV risk, those with CAD equivalent had increased EMVs versus EH (p = 0.002) and chronic inflammatory disorders (p = 0.021). In the whole cohort, RMVs were associated only with the presence of EH (beta = 0.119/p = 0.029). In univariate analysis, PMVs were significantly associated with body mass index/BMI (beta = 0.192/p < 0.001), office and central systolic BP (beta = 0.114/p = 0.031 and beta = 0.131/p = 0.015, respectively). EMVs were associated with age (beta = 0.195/p < 0.001), BMI (beta = 0.108/p = 0.042), office and central systolic BP (beta = 0.159/p = 0.003 and beta = 0.172/p = 0.001, respectively), DM (beta = 0.302/p < 0.001), EH (beta = 0.171/p = 0.002), and dyslipidemia (beta = 0.176/p = 0.001). In multivariate analysis, central systolic BP (beta = 0.150/p = 0.006) predicted PMVs, independently of BMI. Age (beta = 0.141/p = 0.011), central systolic BP (beta = 0.219/p < 0.001), and diabetes mellitus (beta = 0.236/p < 0.001) predicted EMVs, independently of age and dyslipidemia. Conclusions: In a large cohort of patients with divergent CV risk, MVs emerge as potential biomarkers. Central systolic BP is a strong predictor of MVs levels highlighting its predictive value for CV outcomes.