Association of Acute Hyperglycemia and Diabetes Mellitus with Amount of Platelets Derived Microparticles During Acute Myocardial Infarction
Keywords:hyperglycemia, diabetes mellitus, cell derived microparticles, acute myocardial infarction
Objectives. This research aims to investigate whether there is an association between acute hyperglycemia and diabetes mellitus and the amount of circulating platelet-derived microparticles (PDMPs) during acute myocardial infarction (AMI) initial episode.
Methodology. This was a cross-sectional study. Subjects were AMI patients underwent hospitalization. Demography and clinical data were obtained from hospital records. Diabetes mellitus was defined from history of disease, antidiabetic use and/or level of HbA1C ≥6.5%. Levels of HbA1c, admission random and fasting blood glucose levels were measured in hospital laboratory. The PDMPs was measured by flow-cytometry method, by tagging with CD-41 FITC and CD-62 PE markers and threshold size of <1 µm, from venous blood. The circulating PDMPs amount was compared according to glucometabolic state, namely acute hyperglycemia (admission random glucose ≥200 mg/dL and fasting glucose ≥140 mg/dL) and diabetes mellitus. The comparative analysis between group was conducted with Student T tests or Mann-Whitney tests, where applicable.
Results. A total of 108 subjects were included and their data analyzed. Circulating PDMPs amount was significantly lower in subjects with admission random glucose ≥200 mg/dL as compared to those with below level (median (interquartile range (IQR)): 2,710.0 (718.0-8,167.0) count/mL vs. 4,452.0 (2,128.5-14,499.8) count/mL, p=0.05) and in subjects with fasting glucose ≥140 mg/dL as compared to those with below level (median (IQR): 2,382.0 (779.0-6,619.0) count/mL vs. 5,972.0 (2,345.7-14,781.3) count/mL, p=0.006). Circulating PDMPs amount was also significantly lower in diabetes mellitus as compared to non diabetic (median (IQR): 2,655.0 (840.0-5,821.0) count/mL vs. 4,562.0 (2,128.5-15,055.8) count/mL; p=0.007).
Conclusion. Acute hyperglycemia and diabetes mellitus significantly associated with lower amount of circulating PDMPs during the initial episode of AMI.
Anderson JL, Morrow DA. Acute myocardial infarction. N Engl J Med. 2017; 25;376(21):2053-64. PMID: 28538121. https://doi.org/10.1056/NEJMra1606915.
Roth GA, Mensah GA, Johnson CO, et al. Global burden of cardiovascular diseases and risk factors, 1990-2019: Update from the GBD 2019 Study. J Am Coll Cardiol. 2020;76(25):2982-3021. PMID: 33309175. PMCID: PMC7755038. https://doi.org/10.1016/j.jacc.2020.11.010.
Milazzo V, Cosentino N, Genovese S, et al. Diabetes mellitus and acute myocardial infarction: Impact on short and long-term mortality. Adv Exp Med Biol. 2021;1307:153-69. PMID: 32020518. https://doi.org/10.1007/5584_2020_481.
Hartopo AB, Setianto BY, Gharini PP, Dinarti LK. On arrival high blood glucose level is associated with detrimental and fatal hospitalization outcomes for acute coronary syndrome. Cardiol Res. 2011;2(4):160-67. PMID: 28352385. PMCID: PMC5358223. https://doi.org/10.4021/cr56w.
Hartopo AB, Susanti VA, Anggraeni VY. The significance of glycated haemoglobin, randomized admission blood glucose, and fasting blood glucose on in-hospital adverse cardiac events in patients with ST-elevation acute myocardial infarction. J Med Sci. 2022;54(1):28-39. https://journal.ugm.ac.id/bik/article/download/68472/33722.
Undas A, Wiek I, Stêpien E, Zmudka K, Tracz W. Hyperglycemia is associated with enhanced thrombin formation, platelet activation, and fibrin clot resistance to lysis in patients with acute coronary syndrome. Diabetes Care. 2008;31(8):1590-5. PMID: 18487475. PMCID: PMC2494657. https://doi.org/10.2337/dc08-0282.
Wang ZT, Wang Z, Hu YW. Possible roles of platelet-derived microparticles in atherosclerosis. Atherosclerosis. 2016;248:10-6. PMID: 26978582. https://doi.org/10.1016/j.atherosclerosis.2016.03.004.
Hartopo AB, Puspitawati I, Gharini PP, Setianto BY. Platelet microparticle number is associated with the extent of myocardial damage in acute myocardial infarction. Arch Med Sci. 2016;12(3):529-37. PMID: 27279844. PMCID: PMC4889687. https://doi.org/10.5114/aoms.2016.59926.
Hartopo AB, Mayasari DS, Puspitawati I, Mumpuni H. Circulating platelet-derived microparticles associated with postdischarge major adverse cardiac events in ST-elevation acute myocardial infarction. Cardiol Res Pract. 2020;2020:6721584.
Li S, Wei J, Zhang C, et al. Cell-derived microparticles in patients with type 2 diabetes mellitus: A systematic review and meta-analysis. Cell Physiol Biochem. 2016;39(6):2439-50. PMID: 27832642. https://doi.org/10.1159/000452512.
Sun XD, Han L, Lan HT, et al. Endothelial microparticle-associated protein disulfide isomerase increases platelet activation in diabetic coronary heart disease. Aging (Albany NY). 2021;13(14):18718-39. PMID: 34285139. PMCID: PMC8351716. https://doi.org/10.18632/aging.203316.
Jankovic SM. Sample size calculation for comparative trials. Int J Biomed Health. 2018;6(2):62-4.https://doi.org/10.5455/ijbh.2018.6.62-64. https://www.ejmanager.com/mnstemps/220/220-1607282227.pdf?t=1687495410.
Kaur R, Kaur M, Singh J. Endothelial dysfunction and platelet hyperactivity in type 2 diabetes mellitus: Molecular insights and therapeutic strategies. Cardiovasc Diabetol. 2018;17(1):121. PMID: 30170601. PMCID: PMC6117983. https://doi.org/10.1186/s12933-018-0763-3.
Gkaliagkousi E, Nikolaidou B, Gavriilaki E, et al. Increased erythrocyte-
and platelet-derived microvesicles in newly diagnosed type 2 diabetes mellitus. Diabet Vasc Dis Res. 2019;16(5):458-65. PMID: 31046456. https://doi.org/10.1177/1479164119844691.
Tsimerman G, Roguin A, Bachar A, Melamed E, Brenner B, Aharon A. Involvement of microparticles in diabetic vascular complications. Thromb Haemost. 2011; 106(2): 310-21. PMID: 21713319. https://doi.org/10.1160/TH10-11-0712.
Santilli F, Marchisio M, Lanuti P, Boccatonda A, Miscia S, Davì G. Microparticles as new markers of cardiovascular risk in diabetes and beyond. Thromb Haemost. 2016;116(2):220-34. PMID: 27173919.
Zaldivia MTK, McFadyen JD, Lim B, Wang X, Peter K. Platelet-derived microvesicles in cardiovascular diseases. Front Cardiovasc Med. 2017;4:74. PMID: 29209618. PMCID: PMC5702324. https://doi.org/10.3389/fcvm.2017.00074.
Stępień E, Stankiewicz E, Zalewski J, Godlewski J, Zmudka K, Wybrańska I. Number of microparticles generated during acute myocardial infarction and stable angina correlates with platelet activation. Arch Med Res. 2012;43(1):31-5. PMID: 22306248. https://doi.org/10.1016/j.arcmed.2012.01.006.
Suades R, Padró T, Vilahur G, et al. Growing thrombi release increased levels of CD235a(+) microparticles and decreased levels of activated platelet-derived microparticles. Validation in ST-elevation myocardial infarction patients. J Thromb Haemost. 2015;13(10):1776-86. PMID: 26239059. https://doi.org/10.1111/jth.13065.
Kafian S, Mobarrez F, Wallén H, Samad B. Association between platelet reactivity and circulating platelet-derived microvesicles in patients with acute coronary syndrome. Platelets. 2015;26(5):467-73. PMID: 25025694. https://doi.org/10.3109/09537104.2014.940304.
Chyrchel B, Drożdż A, Długosz D, Stępień EŁ, Surdacki A. Platelet reactivity and circulating platelet-derived microvesicles are differently affected by P2Y12 receptor antagonists. Int J Med Sci. 2019;16(2):264-75. PMID: 30745807. PMCID: PMC6367525. https://doi.org/10.7150/ijms.28580.
Marei I, Chidiac O, Thomas B, et al. Angiogenic content of microparticles in patients with diabetes and coronary artery disease predicts networks of endothelial dysfunction. Cardiovasc Diabetol. 2022;21(1):17. PMID: 35109843. PMCID: PMC8812242. https://doi.org/10.1186/s12933-022-01449-0.
How to Cite
Copyright (c) 2023 Hana Anindya Indana, Ira Puspitawati, Dyah Samti Mayasari, Anggoro Budi Hartopo
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of the ASEAN Federation of Endocrine Societies is licensed under a Creative Commons Attribution-NonCommercial 4.0 International. (full license at this link: http://creativecommons.org/licenses/by-nc/3.0/legalcode).
To obtain permission to translate/reproduce or download articles or use images FOR COMMERCIAL REUSE/BUSINESS PURPOSES from the Journal of the ASEAN Federation of Endocrine Societies, kindly fill in the Permission Request for Use of Copyrighted Material and return as PDF file to firstname.lastname@example.org or email@example.com.
A written agreement shall be emailed to the requester should permission be granted.