Figure 1.

The Potential Role of PAI-1⁺ PEV in Coronary Artery Disease

Platelet-derived extracellular vesicles expressing plasminogen activator inhibitor-1 (PAI-1⁺ PEV) promote smooth muscle cell (SMC) phenotypic switching toward a proinflammatory and procalcifying phenotype via the activation of the lipoprotein receptor–related protein 1 (LRP1) receptor. High PAI-1⁺ PEV levels were predictive of major adverse cardiovascular events (MACE). Inhibition of the PAI-1/LRP1 pathway with TM5275 dampened SMC phenotypic switching. Neither PAI-1⁺ PEV levels nor TM5275 affected thrombogenicity, but the exact mechanisms remain to be deciphered. VSMC = vascular smooth muscle cell.