VSMCs were incubated with platelets from HC and KD patients with NCAA for 48 hours, cell proliferation was assessed by, (A) CCK-8 assays (HC: n=17, KD (NCAA): n=16, Mann Whitney test), and (B) BrdU incorporation assays (HC: n=12, KD (NCAA): n=13, Unpaired t test). The expression (C) and quantification (D) of markers for differentiation (ACTA2, CNN1, TAGLN) and dedifferentiation (PCNA, OPN, PDGFRβ) in VSMCs co-cultured with platelets from HC (n=13) and KD patients with NCAA (n=21) were determined by Western blot (Mann Whitney test). Ago2 immunoprecipitation was performed in VSMCs (E) (Ctrl: n=6, KD (NCAA): n=6, Unpaired t test), or VSMCs pre-transfected with miR-223 inhibitor (antagomiR-223) (F) (KD (NCAA)+antagomiRNC: n=6, KD (NCAA)+antagomiR223: n=6, Mann Whitney test), after 24 hours incubation with platelets from KD patients with NCAA, Ago2-associated miR-223 and PDGFRβ mRNA were quantified by quantitative RT-PCR (RT-qPCR). VSMCs transfected with Luc-PDGFRβ (WT) or Luc-PDGFRβ (MT) were co-transfected with miR-223 mimic (agomiR-223) (n=3) or NC-mimic (agomiR-NC) (n=3) in (G), co-cultured with platelets from HC (n=3) or KD patients with NCAA (n=6) in (H), co-transfected with antagomiR-223 (n=6) or NC inhibitor (antagomiR-NC) (n=6) followed by incubation with platelets from KD patients with NCAA as indicated in (I). Luciferase activity was measured with that of Renilla as transfection control (Mann Whitney test or Unpaired t test). Abbreviations: HC, VSMCs co-cultured with platelets from HC; KD (NCAA), VSMCs co-cultured with platelets from KD patients with NCAA. *P<0.05, **P<0.01, ***P<0.001, ****P<0.0001.