Expression of Blood Cells Associated CD Markers and Cardiovascular Diseases

Clinical Applications in Prognosis

Habib Haybar, MD; Masumeh Maleki Behzad, MSc; Saeid Shahrabi, PhD; Narges Ansari, MD; Najmaldin Saki, PhD


Lab Med. 2020;51(2):122-142. 

In This Article

Abstract and Introduction


Background: Cardiovascular diseases (CVDs) are a major cause of mortality worldwide. The results of various studies have shown that abnormality in the frequency and function of blood cells can be involved in CVD complications. In this review, we have focused on abnormalities in the expression of the CD (cluster of differentiation) markers of blood cells to assess the association of these abnormalities with CVD prognosis.

Methods: We identified the relevant literature through a PubMed search (1990–2018) of English-language articles using the terms "Cardiovascular diseases", "CD markers", "leukocytes", "platelets", and "endothelial cells".

Results: There is a variety of mechanisms for the effect of CD-marker expressions on CVDs prognosis, ranging from proinflammatory processes to dysfunctional effects in blood cells.

Conclusion: Considering the possible effects of CD-marker expression on CVDs prognosis, particularly prognosis of acute myocardial infarction and atherosclerosis, long-term studies in large cohorts are required to identify the prognostic value of CD markers and to target them with appropriate therapeutic agents.


A variety of causes can be implicated in the progression of cardiovascular diseases (CVDs), which are a range of diseases involving the heart and blood vessels.[1] Atherosclerosis, abdominal aortic aneurysm (AAA), acute myocardial infarction (AMI), pulmonary arterial hypertension (PAH), postischemic neovascularization, stable angina pectoris (SAP), unstable angina pectoris (UAP), myocarditis, dilated cardiomyopathy, and heart failure are the most common CVDs affecting the cardiovascular system.[2] Many factors have been introduced as risk factors for the onset and progression of CVDs, including physiological and environmental conditions such as sex, age, familial medical history, hypertension, smoking status, hypercholesterolemia, and underlying diseases.[3] Also, the results of several recent studies, including a study by Madjid et al,[4] have reported an association between blood cells, such as white blood cells (WBCs), platelets, and endothelial cells (ECs), with increased incidence of CVDs. In addition, Dragu et al[5] showed that the increase in neutrophils, monocytes, and lymphocytes had a close correlation with rising mortality rates in CVDs. Moreover, platelet dysfunction and ECs damage have been shown[6] to play an essential role in the pathogenesis of CVDs. Considering that the accumulation of inflammatory cells and the secretion of inflammatory cytokines are major factors of CVDs initiation and development, the changes in frequency and function of these cells seem to be among the fundamental causes of thrombosis formation, inflammation initiation, and imbalanced homeostasis in CVDs.[7]

Although significant progress has been made in recent decades concerning the relationship between the frequency of different blood cells with pathogenesis and prognosis of CVDs, few studies, to our knowledge, have focused on independent prognostic roles of the expression of CD (cluster of differentiation) markers in these cells, with respect to CVD risk and outcomes. Considering that the alteration of expression of CD markers reflects changes in the frequency and function of cells, we present a review of the effect of changing expressions of CD markers on different circulating blood cells, as well as the mechanisms associated with these changes, which can affect the progression and prognosis of CVDs.