The association between extracellular vesicles and cardiovascular events: a systematic review and meta-analysis

INTRODUCTION: Cardiovascular diseases are one of the leading causes of death worldwide. By 2022, 11.3 million people will die from a cardiovascular event. Extracellular vesicles (EVs) are particles naturally secreted by cells. The aim of this paper was to determine the association between extracellular vesicles (EVs) and the diagnosis of cardiovascular events.EVIDENCE ACQUISITION: We conducted this review according to the Cochrane collaboration recommendations and the PRISMA Statement. From inception to now, we have performed a search strategy through MEDLINE, EMBASE, and CENTRAL. We included cohort, case-control, and cross-sectional studies involving patients >18 years suffering from at least one cardiovascular pathology. We included 26 studies in the qualitative analysis and identified two types of EVs: exosomes and microvesicles with changes in the expression of non-coding RNAs and other molecules.EVIDENCE SYNTHESIS: Our analyses showed that at least two studies reported increased expression of miR-92-a, miR-155, miR- 126, hsa-miR-30a, CD41b, and CD63. The meta-analysis showed significant differences in the number of EV in patients with heart disease, with an average of 726 million/mL, compared to 496 million/mL in healthy controls and with a mean difference of 46.16 million/mL (23.7-69.9) with a CI 95%.CONCLUSIONS: The EVs are potential markers for some cardiovascular diseases in blood samples.