Macroscopic role of microparticles in cardiovascular disease.

Microparticles, also termed extracellular vesicles (EVs) are novel candidate markers of platelet activation and ongoing inflammation in vivo. Different subtypes of EVs are released from platelets, endothelial cells and leukocytes. Blood concentration of EV subtypes in patients with acute myocardial infarction, stroke and peripheral artery disease correlated with the severity of the disease. Accumulating data indicate that EVs may contribute to the development of atherosclerosis and its complications. Measurement of EV concentrations might become an element of minimally-invasive diagnostic tests, allowing for early diagnosis of cardiovascular disease (CVD), risk stratification and monitoring of therapy in patients with high cardiovascular risk. It also may allow to monitor the response to antiplatelet therapy with acetylsalicylic acid or P2Y12 antagonists. Isolation and detection of EVs have been recently standardized, allowing for further development of research on these promising biomarkers. EV-based tests might eventually be implemented into every-day clinical practice as well as in multicenter clinical trials.