Extracellular Vesicles in Diagnosing Chronic Coronary Syndromes the Bumpy Road to Clinical Implementation

• Published in: International journal of molecular sciences Vol. 21; no. 23; p. 9128
• Main Authors: Dekker, Mirthe, Waissi, Farahnaz, Timmerman, Nathalie, Silvis, Max J. M., Timmers, Leo, de Kleijn, Dominique P. V.
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 30.11.2020; MDPI
• Subjects: Accuracy; Acute coronary syndromes; Angina pectoris; Atherosclerosis - etiology; Atherosclerosis - metabolism; Biomarkers; Cardiovascular disease; Coronary Artery Disease - diagnosis; Coronary Artery Disease - etiology; Coronary Artery Disease - metabolism; Coronary Artery Disease - therapy; Creatinine; Extracellular vesicles; Extracellular Vesicles - metabolism; Humans; Ischemia; Liquid Biopsy - methods; Pain; Patients; Peptides; Plasma; Prognosis; Proteins; Review; Symptom Assessment; coronary artery disease (CAD); liquid biopsy cardiovascular disease; extracellular vesicles (EVs); protein; chronic coronary syndrome (CCS); angina pectoris; biomarker
• ISSN: 1422-0067; 1661-6596; 1422-0067
• DOI: 10.3390/ijms21239128

Coronary artery disease (CAD), comprising both acute coronary syndromes (ACS) and chronic coronary syndromes (CCS), remains one of the most important killers throughout the entire world. ACS is often quickly diagnosed by either deviation on an electrocardiogram or elevated levels of troponin, but CCS appears to be more complicated. The most used noninvasive strategies to diagnose CCS are coronary computed tomography and perfusion imaging. Although both show reasonable accuracy (80–90%), these modalities are becoming more and more subject of debate due to costs, radiation and increasing inappropriate use in low-risk patients. A reliable, blood-based biomarker is not available for CCS but would be of great clinical importance. Extracellular vesicles (EVs) are lipid-bilayer membrane vesicles containing bioactive contents e.g., proteins, lipids and nucleic acids. EVs are often referred to as the “liquid biopsy” since their contents reflect changes in the condition of the cell they originate from. Although EVs are studied extensively for their role as biomarkers in the cardiovascular field during the last decade, they are still not incorporated into clinical practice in this field. This review provides an overview on EV biomarkers in CCS and discusses the clinical and technological aspects important for successful clinical application of EVs.