Thromb Haemost 2023; 123(09): 892-903
DOI: 10.1055/s-0043-57017
Cellular Haemostasis and Platelets

Platelet-Released Extracellular Vesicle Characteristics Differ in Chronic and in Acute Heart Disease

1   Cardiovascular Program-ICCC, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
2   Biochemistry and Molecular Biology Department, Universitat Autònoma de Barcelona (UAB), Cerdanyola del Vallès, Spain
3   Cardiology Department, Hospital Universitario de San Juan, Alicante, Spain
4   Unidad de Investigación en Cardiología, Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO), València, Spain
5   Centro de Investigación Biomédica en Red Cardiovascular (CIBER-CV), Instituto de Salud Carlos III, Madrid, Spain
5   Centro de Investigación Biomédica en Red Cardiovascular (CIBER-CV), Instituto de Salud Carlos III, Madrid, Spain
6   Heart Failure Group, Cardiology Department, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
1   Cardiovascular Program-ICCC, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
1   Cardiovascular Program-ICCC, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
1   Cardiovascular Program-ICCC, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
5   Centro de Investigación Biomédica en Red Cardiovascular (CIBER-CV), Instituto de Salud Carlos III, Madrid, Spain
1   Cardiovascular Program-ICCC, Institut d'Investigació Biomèdica Sant Pau (IIB SANT PAU), Barcelona, Spain
5   Centro de Investigación Biomédica en Red Cardiovascular (CIBER-CV), Instituto de Salud Carlos III, Madrid, Spain
7   UAB-Chair Cardiovascular Research, Barcelona, Spain
› Author Affiliations
Funding This work was supported by the Spanish Society of Cardiology [“SEC-2016” to L.B.; “Investigación Clínica 2017” to A.C.]; Spanish Ministry of Economy and Competitiveness of Science “Agencia Estatal de Investigación (AEI)” Proj Ref AEI / 10.13039/501100011033-[PID2019-107160RB-I00] to L.B.; Institute of Health Carlos III (ISCIII) [Red RICORS TERAV- RD21/0017/0013 to L.B.; FIS PI19/01687 to T.P.]; CIBERCV to L.B. and A.C., Sociedad Valenciana de Cardiología 2017 to A.C.; and cofounded by FEDER “Una Manera de Hacer Europa.” We thank Fundación Jesus Serra and Fundación de Investigación Cardiovascular (Barcelona, Spain) for their continuous support. A.V.-F. and N.M.-G. are the recipients of a research contract from the Cardiovascular Program-ICCC (IR-HSCSP). R.S. is the recipient of a Beatriu de Pinós Fellowship [2019BP00211] from the University and Research Grants Management Agency (Government of Catalonia) co-funded by COFUND-Marie Skłodowska-Curie Actions in the Horizon 2020 program (European Commission, contract number 801370).


Background Extracellular vesicles (EVs), shed in response to cell activation, stress, or injury, are increased in the blood of patients with cardiovascular disease. EVs are characterized by expressing parental-cell antigens, allowing the determination of their cellular origin. Platelet-derived EVs (pEVs) are the most abundant in blood. Although not universally given, EVs generally express phosphatidylserine (PS) in their membrane.

Objectives To investigate pEVs in chronic and acute conditions, such as chronic heart failure (CHF) and first-onset acute coronary syndrome (ACS), in patients treated as per guidelines.

Methods EVs in CHF patients (n = 119), ACS patients (n = 58), their respective controls (non-CHF [n = 21] and non-ACS [n = 24], respectively), and a reference control group (n = 31) were characterized and quantified by flow cytometry, using monoclonal antibodies against platelet antigens, and annexin V (AV) to determine PS exposure.

Results CHF patients had higher EVs-PS numbers, while ACS had predominantly EVs-PS+. In contrast to ACS, CHF patients had significantly reduced numbers of pEVs carrying PECAM and αIIb-integrin epitopes (CD31+/AV+, CD41a+/AV+, and CD31+/CD41a+/AV+), while no differences were observed in P-selectin-rich pEVs (CD62P+/AV+) compared with controls. Additionally, background etiology of CHF (ischemic vs. nonischemic) or ACS type (ST-elevation myocardial infarction [STEMI] vs. non-STEMI [NSTEMI]) did not affect pEV levels.

Conclusion PS exposure in EV and pEV-release differ between CHF and ACS patients, with tentatively different functional capacities beyond coagulation to inflammation and cross-talk with other cell types.

Authors' Contribution

L.B., T.P., S.M., and A.C. designed the research. A.V.-F. performed experiments. A.V.-F., T.P., and L.B. analyzed the results. A.V.-F., N.M.-G., A.C., R.S., S.M., T.P., and L.B. wrote and revised the manuscript.

Publication History

Received: 01 December 2022

Accepted: 14 March 2023

Article published online:
19 April 2023

© 2023. Thieme. All rights reserved.

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