EP_077. Integrating monocyte activation markers into cardiovascular risk assessment: A pilot study in a subclinical population

Nur Balqis Sabri¹, Sabariah Md Noor^2*, Fezah Othman¹

1. Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia

2. Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia

*Corresponding author: Sabariah Md Noor. This email address is being protected from spambots. You need JavaScript enabled to view it.

ABSTRACT

INTRODUCTION: Cardiovascular disease (CVD) remains the leading global cause of mortality, emphasising the need for accurate risk prediction tools. The Framingham Risk Score (FRS) is a tool to predict cardiovascular disease risk, incorporating age, gender, blood pressure, cholesterol levels, and smoking status. However, despite their established role in atherosclerosis progression, it omits inflammatory markers. Monocyte activation is a key player in the progression of atherosclerotic plaque, which can be a potential complementary marker in CVD risk prediction.

OBJECTIVE(S): This study aims to integrate monocyte activation markers as an adjunct to traditional FRS parameters for improved prediction of subclinical cardiovascular risk.

MATERIALS & METHODS: This study utilised stored peripheral blood mononuclear cells (PBMCs) who attended the family health care clinic and were unaware of cardiovascular disease.  Demographic and clinical data such as age, gender, systolic blood pressure, total cholesterol, HDL cholesterol, and smoking status were collected to reflect FRS parameters. Monoclonal antibodies against CD14, CD16, CD86, and CCR2 were used to classify monocytes into classical (CD14++CD16–), intermediate (CD14++CD16+), and non-classical (CD14+CD16++) subsets.

RESULTS: Among 80 patients (median age 53 years; 65% female), classical, intermediate, and non-classical monocytes showed median percentages of 5.23%, 0.42%, and 10.75%, respectively. CCR2 expression was highest in classical monocytes, followed by intermediate and non-classical subsets. Spearman correlation analysis revealed a significant negative association between total cholesterol and classical monocytes (r = –0.260, p = 0.020). CCR2 expression in classical monocytes positively correlated with age (r = 0.227, p = 0.043), while HDL-C was positively associated with CCR2 expression in intermediate monocytes (r = 0.283, p = 0.011).

CONCLUSION: These findings suggest that monocyte profiling may reflect early immune activation consistent with subclinical atherosclerosis. This supports the potential integration of monocyte markers into cardiovascular risk prediction strategies.

KEYWORDS: Cardiovascular Disease, Framingham Risk Score, Monocyte Activation Markers, Flow Cytometry, Risk Prediction