Clinical Edge

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Future Ischemic Events in Patients with FH

Patients with familial hypercholesterolemia (FH) who are going to suffer a cardiovascular event (CVE) within a mean period of 3.3 years, despite being treated according to guidelines, have ongoing innate immune cell and platelet activation, a new study found. Researchers investigated the prognostic circulating microvesicles (cMVs) signature for future major CVE presentation in patients with FH. Liquid biopsies from genetically characterized patients with FH without clinical manifestation of disease at entry that were going to suffer a CVE within a mean period of 3.3 years postsampling (n=92), and from age/CV risk factor/treatment-matched patients with FH that did not suffer an event within the same time period (non-CVE, n=48) were included. Among the findings:

  • Patients with CVE had higher number of overall procoagulant annexin V+-cMVs than non-CVE.
  • Pan-leukocyte-derived and neutrophil-derived cMVs, as well as activated platelet-derived cMVs, were significantly higher in patients with CVE.
  • Baseline number of cMVs derived from lymphocytes, neutrophils, and activated platelets were positively associated with mortality at follow-up.
  • Patient-risk calculated by classical CV risk-factor scores did not correlate with cMVs.


Suades R, PadrĪŒ T, Crespo J, et al. Liquid biopsy of extracellular microvesicles predicts future major ischemic events in genetically characterized familial hypercholesterolemia patients. [Published online ahead of print April 18, 2019]. Arterioscler Thromb Vasc Biol. doi:10.1161/ATVBAHA.119.312420.