Proteomic profiling of extracellular vesicles in ST-elevation acute myocardial infarction

Time of primary review: 21 days Primary percutaneous coronary intervention (pPCI) is the gold standard for treating ST-elevation myocardial infarction (STEMI). However, despite a timely and successful infarct-related artery re-opening, a significant number of patients experience a decline in left ventricular ejection fraction (LVEF).1 This decline is a powerful predictor of long-term morbidity and mortality, including an increased risk of heart failure.2,3 Therefore, identifying early biomarkers that can predict which patients are at high risk for LVEF worsening is a critical unmet need in clinical cardiology. Our study aimed to address this by exploring the proteomic profile of extracellular vesicles (EVs). EVs are tiny, lipid-bilayer vesicles released by various cells. They contain a cargo of proteins, lipids, and nucleic acids that reflect the state of their originating cells and can be transferred to recipient cells, influencing their function.4,5 Following STEMI, EVs from cardiomyocytes, endothelial cells, and inflammatory cells are released into the bloodstream, making them ideal candidates for discovering new biomarkers.4,5 We hypothesized that the protein content of these circulating EVs could provide a snapshot of the ongoing cellular damage and repair processes, allowing for the early prediction of LVEF outcomes.