Plasma leukocyte-derived extracellular vesicles are related to target vessel revascularization in off-pump coronary artery bypass grafting.

Abstract

Introduction: In multivessel coronary disease, interventional therapy is recommended to improve symptoms and survival. Inflammatory activation is postulated as one of the coronary atherosclerosis progression risk factors and prognostic indicators of surgical intervention. Counts of plasma extracellular vesicles (EVs) derived from erythrocytes, leukocytes, and platelets are elevated in patients with inflammatory diseases, including atherosclerosis-based cardiovascular diseases.

Aim: We aimed to estimate the association between blood flow measurements in coronary artery bypass grafts and EV plasma count changes in patients undergoing surgical coronary revascularization.

Material and methods: Forty-four consecutive patients who underwent surgical off-pump revascularization (33 males, 75%) in the median (Q1-Q3) age of 65 (58-69) were included. The blood flow in the implanted coronary artery bypass grafts was measured intraoperatively. EV counts were measured at baseline (hospital admission) and on the 1^st and 3^rd postoperative days. The numbers of EVs from erythrocytes (CD235+), leukocytes (CD45+) and platelets (CD61+) were measured using flow cytometry with fluorescently labeled antibodies against specific antigens exposed on the EVs.

Results: The numbers of leukocyte-derived EVs were lower in patients who received a LIMA-LAD graft (p = 0.020). The total EV plasma count changes were found significant for RIMA-LAD grafting (p = 0.028) and LIMA-LAD (p = 0.015) in arterial and arterio-venous grafting, respectively.

Conclusions: Surgical revascularizations affect EV plasma count, including significantly lower postoperative values of leukocyte-derived EVs related to left descending artery grafting.