Circulating plasma exosomes reflect the severity of myocardial damage in STEMI patients

Selected Abstract - SITeCS Congress 2023

Andrea Baggiano
Centro Cardiologico Monzino IRCCS, Milan, Italy and Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
Patrizia Amadio
Centro Cardiologico Monzino IRCCS, Milan, Italy
Jeness Campodonico
Centro Cardiologico Monzino IRCCS, Milan, Italy
Sebastiano Gili
Centro Cardiologico Monzino IRCCS, Milan, Italy
Andrea Annoni
Centro Cardiologico Monzino IRCCS, Milan, Italy
Gianluca De Dona
Centro Cardiologico Monzino IRCCS, Milan, Italy
Maria Ludovica Carerj
Centro Cardiologico Monzino IRCCS, Milan, Italy
Francesco Cilia
Centro Cardiologico Monzino IRCCS, Milan, Italy
Alberto Formenti
Centro Cardiologico Monzino IRCCS, Milan, Italy
Laura Fusini
Centro Cardiologico Monzino IRCCS, Milan, Italy and Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
Cristina Banfi
Centro Cardiologico Monzino IRCCS, Milan, Italy
Paola Gripari
Centro Cardiologico Monzino IRCCS, Milan, Italy
Calogero Claudio Tedesco
Centro Cardiologico Monzino IRCCS, Milan, Italy
Maria Elisabetta Mancini
Centro Cardiologico Monzino IRCCS, Milan, Italy
Mattia Chiesa
Centro Cardiologico Monzino IRCCS, Milan, Italy
Riccardo Maragna
Centro Cardiologico Monzino IRCCS, Milan, Italy
Francesca Marchetti
Centro Cardiologico Monzino IRCCS, Milan, Italy
Marco Penso
Centro Cardiologico Monzino IRCCS, Milan, Italy
Luigi Tassetti
Centro Cardiologico Monzino IRCCS, Milan, Italy
Alessandra Volpe
Centro Cardiologico Monzino IRCCS, Milan, Italy
Alice Bonomi
Centro Cardiologico Monzino IRCCS, Milan, Italy
Giancarlo Marenzi
Centro Cardiologico Monzino IRCCS, Milan, Italy
Gianluca Pontone
Centro Cardiologico Monzino IRCCS, Milan, Italy and Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
Silvia Stella Barbieri
Centro Cardiologico Monzino IRCCS, Milan, Italy

Abstract

Exosomes are small extracellular vesicles involved in intercellular communication and they contribute to inflammation, coagulation and vascular injury. Exosomes have demonstrated a great potential as diagnostic markers of disease, however their ability to reflect myocardial damage assessed by Cardiac Magnetic Resonance (CMR) in ST-segment elevation myocardial infarction (STEMI) is still unknown. To fill this gap, plasma exosomes were isolated from 42 STEMI patients treated by primary percutaneous coronary intervention (pPCI) and evaluated by CMR between days 3 and 6. Exosome concentration and size were measured by Nanoparticle Tracking Analysis, surface epitopes by flow cytometry, and platelet marker expression by ELISA kit.
Exosome levels were greater in patients with anterior STEMI (p = 0.0001), with the culprit lesion located in LAD (p = 0.045), and in those who underwent late revascularization (p = 0.038). A smaller exosome size was observed in patients with a low myocardial salvage index (MSI, p = 0.014). Exosomes of patients with microvascular obstruction (MVO) had smaller dimension (p < 0.002) and lower expression of the platelet marker CD41–CD61 (p = 0.039). Exosome size and CD41–CD61 expression were independent predictors of MVO/MSI (OR [95% CI]: 0.93 [0.87–0.98] and 0.04 [0–0.61], respectively).
In conclusion, we reported for the first time the ability of exosomes isolated a few days after STEMI to reflect myocardial damage. In particular, the exosome size and expression of the platelet marker CD41–CD61, likely reflecting the level of circulating platelet-derived exosome, were independent predictors of MVO and low MSI that are both predictors of short-term prognosis of acute STEMI after pPCI treatment and are key variables for risk-stratification of patients after STEMI. This finding paves the way for the development of a new strategy for the timely identification of high-risk patients and their treatment optimization.

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