To Örebro University

BACKGROUND: Given the role of platelets in coronary artery disease (CAD), assessment of a soluble platelet-activation marker may be useful to improve thrombotic risk stratification.

OBJECTIVES: This study aimed to perform a meta-analysis investigating the association between levels of 14 such markers associated with CAD.

METHODS: PubMed, Web of Science, and Excerpta Medica dataBASE (EMBASE) were searched until November 2024. The primary end point was the difference in levels of 11-dehydro-thromboxane B2, 2,3-dinor-thromboxane B2, β-thromboglobulin, soluble CD40L (sCD40L), glycocalicin, glycoprotein (GP)V, GPVI, matrix metalloproteinase (MMP)-9 and MMP-2, platelet factor (PF)4, soluble (s) P-selectin, SCUBE1, serotonin and thrombospondin (TSP)-1 between patients with CAD and healthy subjects (HSs) in plasma and/or serum. When possible, patients with CAD were stratified into acute coronary syndrome (ACS) and chronic coronary disease. Standardized mean difference (SMD) was calculated.

RESULTS: Due to heterogeneity in the assessed studies, meta-analysis was performed for sCD40L, soluble GPV, MMP-9, PF4, sP-selectin, SCUBE1, and TSP-1. All markers but TSP-1 were significantly elevated in patients with CAD compared with HSs. Differences in sCD40L and SCUBE1 were statistically significant only when studies that assessed plasma were combined with those that assessed serum. When compared with HSs, the differences were bigger in patients with ACS than patients with chronic coronary disease for MMP-9 (SMD, 2.49 vs 0.49), PF4 (SMD, 2.01 vs 0.96), and sP-selectin (SMD, 1.81 vs 0.63). Publication bias was identified for sCD40L and, in ACS, for sP-selectin and PF4.

CONCLUSION: The increased levels of sCD40L, soluble GPV, MMP-9, PF4, sP-selectin, and SCUBE1 in patients with CAD compared with HSs provide a rationale for designing new studies to address the potential of such molecules as biomarkers for thrombotic risk stratification.