Abstract 097: Diagnosis of Atherosclerotic Coronary Heart Disease using Plasma Extracellular Vesicle Proteins

Abstract

Atherosclerosis is the underlying syndrome of Cardiovascular Disease (CVD). Ischemic Heart Disease and Stroke are cardiovascular events both due to atherosclerosis that are the number 1 and 2 cause of death in the world and expect to increase especially in Asia. Ischemic heart disease (IHD) comprises 3 entities: stable coronary artery disease (SCAD), unstable angina (UA) and myocardial infarction (MI). Despite its large numbers, diagnosis IHD is challenging, as many patients present with atypical symptoms with women have a different symptom sensation than men. Troponins are the main diagnostic tool for detection of MI. Blood biomarkers for SCAD (typically causing stable angina) and UA, however, are not available. These diagnoses frequently require hospital visits/admissions for time-consuming and costly (non)invasive tests. Extracellular vesicles are composed of a lipid bilayer containing cytosolic, membrane and nuclear molecules derived from the cell and cell compartments of origin and released by the cell into extracellular biofluids. Using proteomics, we identified a plasma extracellular vesicle protein signature of inflammatory and coagulation proteins in different plasma vesicle subpopulations that can identify UA and SCAD patients. This signature was verified for UA in 60 acute chest pain patients (AUC 0.93), and for SCAD in 60 chest pain patients scheduled for heart perfusion imaging (AUC 0.86). This shows that plasma extracellular vesicle proteins can be used for early diagnosis of SCAD and UA and underlines the biological role for extracellular vesicles in atherosclerosis.