What question did this study set out to answer?

To determine whether elevated levels of circulating monocyte-platelet aggregates (MPA) can serve as an early diagnostic marker for acute myocardial infarction (AMI).

April 30, 2026Journal of the American College of Cardiology

Circulating monocyte-platelet aggregates are an early marker of acute myocardial infarction

Q: What are the key findings of this study?

Elevated circulating monocyte-platelet aggregates were significantly associated with acute myocardial infarction, with the highest quartile having an adjusted OR of 10.8 (95% CI 3.6-32.0).

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Acute myocardial infarction (n=211). Intervention: Elevated circulating monocyte-platelet aggregates (MPA) vs. Lowest quartile of MPA. Primary outcome: Acute myocardial infarction (OR 10.8, 95% CI 3.6-32.0, p=<0.0001).

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Key result

Elevated monocyte-platelet aggregates linked to ~11-fold higher odds of acute myocardial infarction.

OR 10.8
95% CI 3.6-32.0
P<0.0001
n=211

Why the study?

Commonly used blood markers of AMI reflect myocardial cell death but do not capture earlier pathophysiologic processes such as plaque rupture and platelet activation.

Can elevated levels of circulating monocyte-platelet aggregates (MPA) identify patients with acute myocardial infarction early after symptom onset?

Key Points

To determine whether elevated levels of circulating monocyte-platelet aggregates (MPA) can serve as an early diagnostic marker for acute myocardial infarction (AMI).
Measured circulating MPA in a blinded fashion via whole blood flow cytometry in N=211 consecutive emergency department patients admitted for chest pain to rule out AMI at a single center between October 1998 and November 1999.
Diagnosed AMI using a creatine kinase-MB (CK-MB) isoenzyme fraction greater than three times the control level.
Patients with AMI (n = 61) had significantly higher circulating MPA levels compared to patients without AMI (n = 150) (11.6 ± 11.4 vs. 6.4 ± 3.6, mean ± SD, p < 0.0001).
Compared to the lowest MPA quartile (odds ratio [OR] = 1.0), age-adjusted odds of AMI were 2.1 (95% CI: 0.7, 6.8) for the 2nd quartile, 4.4 (95% CI: 1.5, 13.1) for the 3rd quartile, and 10.8 (95% CI: 3.6, 32.0) for the 4th quartile.
Circulating MPA peaked in AMI patients presenting within 4 hours of symptom onset (14.4 vs. 9.4 after 4 h and 7.0 after 8 h, p < 0.001), remaining elevated at 13.3 in 57% (35/61) of AMI patients who presented with normal CK-MB ratios.

Study Design

Type

Observational (n=211)

Blinding

Blinded

Multicenter

Structured PICO

Can elevated levels of circulating monocyte-platelet aggregates (MPA) identify patients with acute myocardial infarction early after symptom onset?

Population

211 consecutive patients presenting to the emergency department with chest pain and admitted to rule out acute myocardial infarction.

Exposure

Measurement of circulating monocyte-platelet aggregates (MPA) by whole blood flow cytometry

Comparator

Patients without AMI (n=150)

Outcome

Diagnosis of acute myocardial infarction (defined by CK-MB fraction greater than three times control)surrogate

Main Result

Odds Ratio: 10.8 (95% CI 3.6–32)

p-value: p=<0.0001

Discussion

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Implication

Circulating monocyte-platelet aggregates are significantly elevated in patients with acute myocardial infarction and may serve as an early diagnostic marker, even before traditional biomarkers like CK-MB become abnormal.

Cite This Study

Furman et al. (2001) conducted an observational in Acute myocardial infarction (n=211). Elevated circulating monocyte-platelet aggregates (MPA) vs. Lowest quartile of MPA was evaluated on Acute myocardial infarction (OR 10.8, 95% CI 3.6-32.0, p=<0.0001). Elevated circulating monocyte-platelet aggregates were significantly associated with acute myocardial infarction, with the highest quartile having an adjusted OR of 10.8 (95% CI 3.6-32.0).

synapsesocial.com/papers/69f372ec09d307f586db4748 https://doi.org/10.1016/s0735-1097(01)01485-1

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Circulating monocyte-platelet aggregates are an early marker of acute myocardial infarction

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Circulating monocyte-platelet aggregates are an early marker of acute myocardial infarction

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

Also Consider