Assessing the relationship between circulating microparticles and coronary artery disease severity using the SYNTAX score: A single-centre comparative study.

Abstract

Objective: Immune-inflammatory processes play a central role in the progression of atherosclerosis. The objective of this study is to evaluate whether circulating microparticles (MPs) correlate with coronary artery disease (CAD) severity defined by SYNTAX Score II in patients aged <45 and >45 years.

Methods: This single-centre, open-label, comparative study enrolled 80 patients with angiographically confirmed CAD (40 aged <45 years and 40 aged >45 years) between June 2023 and July 2024. Forty age- and sex-matched individuals with angiographically normal coronary arteries served as the control group. Blood samples were analysed for total MPs, endothelial MPs, platelet-derived MPs, and leukocyte markers (CD45, CD19, CD3, CD16).

Results: The study population included a younger cohort in Group I (<45 years; mean age 39 ± 5 years) and an older cohort in Group II (>45 years; mean age 63.9 ± 7.1 years). SYNTAX I and II scores were significantly higher in Group II compared with Group I. Circulating microparticles, including total, endothelial, platelet-derived, CD45⁺, CD19⁺, CD3⁺, and CD16⁺ microparticles, were significantly elevated in both CAD groups compared with controls, with higher levels observed in Group II. Significant positive correlations were observed between several microparticle subtypes and SYNTAX scores. ROC analysis demonstrated that total microparticles (AUC 0.836) and CD16⁺ microparticles (AUC 0.856) were the strongest predictors of high SYNTAX II scores.

Conclusions: Our study highlights the potential of MPs as biomarkers for early detection and risk stratification of CAD, supporting more personalised and effective treatment strategies.