Mac-1 Alongside Platelet-Monocyte Aggregates as Potential Markers in Acute Coronary Syndrome: A Case-Control Study

Abstract

Objective: Cardiovascular diseases (CVDs) are the leading cause of death worldwide, with atherosclerosis servingas a primary factor in their development. Platelets, leukocytes, and their interactions play a crucial role ininitiating and amplifying atherosclerosis. This study aims to evaluate the levels of platelet-monocyte aggregates (PMA)and specific integrins involved in leukocyte recruitment, including macrophage-1 antigen (Mac-1) and lymphocytefunction-associated antigen-1 (Lfa-1), in patients with acute coronary syndrome (ACS).Materials and Methods: In this case-control study, thirty-two subjects with ACS and 30 healthy individuals participated.It aimed to evaluate PMA expression and the median fluorescence intensity (MFI) of Mac-1 and Lfa-1 using flowcytometry. Dot plots and Pearson correlation coefficient were employed to examine the relationship between PMA,Mac-1, and Lfa-1. Multilevel model analysis was used to explore the effects and relationships of various parameters,including Mac-1 and Lfa-1, on PMA. Finally, receiver operating characteristic (ROC) curves were utilized to assessthe diagnostic accuracy of PMA, Mac-1, and Lfa-1 markers.Results: It was observed that patients had higher PMA levels compared to the control group (58.99 ± 16.27 vs.29.99 ± 4.19 in controls, P<0.001), which correlated with PLT (ρ=0.512, P=0.035). Additionally, CD18 and CD11bexpression on monocytes were significantly elevated in patients (P<0.001) and were positively associated with PMA(β=19.09, P<0.001; β=6.90, P=0.022), but no significant relationship between CD11a and PMA was observed (β=5.06,P=0.315). PMA and Mac-1 were identified as better markers for differentiating patients from healthy individuals.(respectively, AUC=0.94, Sensitivity= 0.84, specificity=0.98; AUC=0.84, Sensitivity= 0.93, specificity=0.70).Conclusion: The study results indicated an increase in both Mac-1 and PMA levels in patients with ACS. Additionally,the significant association observed between Mac-1 and PMA in the patient group suggests a potential relationshipbetween these markers and ACS.

Keywords

• acute coronary syndrome
• integrins
• macrophage-1 antigen
• platelet-monocyte aggregates
• thromboinflammation