Circulating exosomal miR-550a-5p/miR-665 identify coronary microvascular dysfunction and drive endothelial–myocyte crosstalk in type 2 diabetes

Exosomal miR-550a-5p, together with miR-665, functions as a dual-utility signal, serving as an accessible biomarker for coronary MD and as a mechanistic mediator in endothelial-to-cardiomyocyte exosomal signaling. These findings support earlier detection, risk stratification, and mechanism-guided intervention in T2DM. Future priorities include external validation, longitudinal kinetic assessment, and target-network mapping.