Increased levels of endothelial microparticles CD144 (VE-Cadherin) positives in type 2 diabetic patients with coronary noncalcified plaques evaluated by multidetector computed tomography (MDCT)
Résumé
Objective: The combination of both morphological and cellular markers of subclinical atherosclerosis, in addition to conventional risk factors, may help to improve cardiovascular prevention in type 2 diabetic patients. The aim of our cross-sectional study was to evidence a putative increase in endothelial (EMP) or platelet (PMP) microparticles, in type 2 diabetic patients with coronary noncalcified plaques detected by multidetector CT (MDCT).
Methods and results: Microparticles and coronary MDCT were assessed in 56 type 2 diabetic patients with different cardiovascular risk levels. Both EMP (r=0.35, p=0.022) and PMP (rho=0.34, p=0.022) were correlated with hsCRP. EMP were elevated in patients with acute coronary syndromes (p=0.034). EMP count was significantly higher in the presence of noncalcified diseased segments (p=0.01). By contrast, there was no association between hsCRP and noncalcified atheroma. This increase in EMP in noncalcified diseased segment carriers remained borderline significant after adjustment for coronary heart disease and hsCRP. Conversely, there was no association of PMP count with noncalcified diseased segments and no difference in PMP count between patients with and without acute coronary syndrome. No significant association between either EMP and PMP counts and mixed or calcified diseased segments was observed.
Conclusions: We report for the first time an association between plasma EMP-CD144+ and coronary noncalcified plaques assessed by MDCT in a population of type 2 diabetic patients. EMP might be used as a surrogate marker of unstable plaques, and might help to improve cardiovascular prediction in diabetic patients with intermediate risk.