Background: Despite the recent advances in the treatment of Acute Coronary Syndromes
(ACS), patients with ACS are still exposed to an increased risk for adverse cardiovascular events, while
their prognosis is difficult to determine. Experimental and clinical studies have shown that cell-derived
Microparticles (MPs) are associated with the underlying pathophysiological processes that are responsible
for atherogenesis and may be causally implicated in the induction of atherothrombosis.
Objective: In the present article, we aimed to review the available evidence regarding the predictive
role of MPs in patients with ACS.
Results: Evidence suggests that endothelial MPs are associated with future adverse cardiovascular
events in patients with ACS. Platelet-derived MPs have been excessively studied, since they have been
found to trigger the coagulation cascade; however, their role as predictors of future cardiovascular
events remains debatable. The role of red blood cell-derived MPs is more intriguing; they have been
proposed as markers of ongoing thrombosis in patients with ACS, while previous studies have shown
that they have anti-coagulant properties in healthy individuals. Leukocyte-derived MPs may also have a
predictive role, although the studies regarding these are still limited. Last but not least, it was an interesting
discovery that circulating MPs can provide information regarding the angiographic lesions in
patients with ACS.
Conclusion: The concept of MPs as potential circulating biomarkers in patients with ACS holds much
promise. However, large-scale clinical studies are required to evaluate whether the measurement of
plasma MPs could be of clinical significance and, thus, dictate a more aggressive treatment strategy in
patients with high levels of circulating MPs.