Occurrence of Platelet–Monocyte Aggregates in Patients with Metabolic Disorders and Effect of Direct Anticoagulants

Platelet-monocyte aggregates (PMA) are modern biomarkers for the early onset of cardiovascular diseases (CVD). PMA occur in the presence of activated platelets (AP), whose incidence is higher in patients with metabolic diseases. These patients frequently benefit from anticoagulant therapy, particularly in advanced disease stages. However, the impact of these drugs on PMA occurrence is unknown.Blood samples from healthy volunteers, patients with type 1 diabetes mellitus (DMT1), type 2 diabetes mellitus (DMT2), dyslipidemia (hypercholesterolemia), and severe forms of familial hypercholesterolemia (FH) were analyzed by flow cytometry to detect both AP and PMA. Subsequently, blood samples were treated with four direct anticoagulants (rivaroxaban, apixaban, dabigatran, or argatroban, all at a final concentration of 1 µM), and PMA were again detected. Anthropological and biochemical parameters were recorded and correlated with AP and PMA.AP levels were higher solely in DMT2 patients, but PMA occurrence was significantly increased in all patient groups in comparison to that of generally healthy donors, except for FH patients. No sex-related differences were observed, but an increasing trend in AP and PMA incidence was observed with increasing age and BMI. Significant correlations of AP and PMA with anthropological and biochemical parameters were found solely in some groups of patients or in some anticoagulant-treated samples. Only argatroban and apixaban-treated samples significantly decreased PMA occurrence, and this was observed solely in the dyslipidemia patient group.These findings suggest a potential positive outcome of anticoagulant treatment for metabolic disease patients and confirm PMA as a sensitive marker in patients with metabolic diseases.