Prediction of recurrent cardiovascular events within
the first year after a type 2 acute myocardial infarction in men under 45 years
of age
Gorbacheva N.S., Veselovskaya N.G., Nikolaeva
M.G. et al.
ABSTRACT
In recent years,
cardiovascular diseases (CVD) have remained among the top three causes of
mortality and disability worldwide. In this regard, the search for and study of
risk factors, identification of pathogenetic
mechanisms underlying cardiovascular complications, and improvement of primary
and secondary prevention methods continue. Currently, there is emerging
evidence on important components of the hemostatic system, including
extracellular formations of various sizes — microvesicles
of different or igins. Research into their role in
the pathogenesis of acute arterial thromboses is ongoing. Microvesicles
(EVs) are extracellular structures that trigger a cascade of mechanisms
affecting changes in the vascular endothelium. The aim of the study is to investigate
the role of microvesicles of different origins in the
risk of recurrent cardiovascular events within 1 year after a type 2 acute
myocardial infarction (AMI) in men under 45 years of age.
Methods. The study
included young men under 45 years of age with type 2
AMI, confirmed by coronary angiography and elevated markers of myocardial
injury. The control group consisted of young men under 45 years of age without
chronic diseases. The main group consisted of 60 patients,
the control group included 30 healthy volunteers. The study investigated microvesicles of platelet (CD41+), endothelial
(CD31+ — platelet endothelial adhesion molecule), and leukocyte
origin (CD45+) in peripheral blood. To determine the quantity of microvesicles, venous blood samples were examined
using 0.32% sodium citrate anticoagulant and processed within 2 hours after
blood collection. The samples were processed through
sequential centrifugation. All measurements were performed
on a CytoFlex flow cytometer (Beckman Coulter, USA)
equipped with three lasers: Red (638 nm), Blue (488 nm), and Violet (405 nm).
Extracellular vesicles were separated by diameter, and
measurements were taken for unstained samples to set positive gates.
Subsequently, the material was stained, mixed again,
and measured after diluting the sample 100 times using phosphate-buffered
saline (PBS x10, Bio-Rad). In each analysis, 1 million events were recorded at a flow rate of 60 µl/min. For statistical
processing, the parameter of the number of events (extracellular events) per 1 µl was used.
Results. While
studying microvesicles, it was
found that the levels of CD31+ EVs (endothelial) and CD45+ EVs
(leukocyte-derived) were comparable in healthy volunteers and patients with
type 2 AMI under 45 years of age. A decrease in the expression of CD31+ EVs by
the endothelial glycocalyx was
observed, which may indicate its consumption. A difference was observed in the number of CD45+ EVs in patients with
recurrent cardiovascular events (CVE) within one year, while during a CVE episode,
the number of CD31+ EVs decreased.
Conclusion. During the acute phase of type 2 AMI, the
level of CD45+ EVs was statistically significantly higher in patients who
subsequently experienced recurrent CVEs within one year.
Keywords: type 2 acute myocardial infarction, microvesicles, cardiovascular complications, risk factors,
hemostasis, recurrent cardiovascular events.
For citation:
Gorbacheva N.S., Veselovskaya N.G., Nikolaeva M.G.
et al. Prediction of recurrent cardiovascular events within the first year
after a type 2 acute myocardial infarction in men under 45 years of age. International Journal of Heart
and Vascular Diseases. 2025. 13(45):23– 29. DOI:
10.24412/2311-1623-2025-45-28-36