Cardiovascular diseases are one of the leading causes of mortality and morbidity, and the search for biomarkers for risk stratification is a challenge. Microvesicles are cell fragments generated by all cells in the body. They are considered not only as vectors of biological information involved in cell communication but also as emerging biomarkers with clinical relevance. Indeed, elevated plasmatic levels of microvesicles have been reported in various cardiovascular settings including atherosclerosis, acute coronary syndromes, ischemic strokes, as well as in thrombosis associated with cancer or infection as COVID 19, where microvesicles were identified as promising biomarkers for early detection of patient with severe forms of the disease and for prediction of thrombotic complications. Despite the fact that the field has long been hampered by technical difficulties, the ongoing progress in developing highly sensitive techniques and standardization efforts impulsed by Scientific societies working in partnership with research teams are crucial for implementing microvesicles analyses in the clinic. Large prospective studies are required to confirm which microvesicle subpopulations are of prognostic relevance and can be used as a promising biomarker to develop personalized cardiovascular medicine. (C) 2020 Published by Elsevier Masson SAS on behalf of l'Academie nationale de medecine.