title: Circulating endothelial progenitor cells predict coronary artery disease severity.
abstract: BACKGROUND
  Circulating endothelial progenitor cells (EPCs) may play an important role in the body's defense against atherosclerosis. Previous studies have shown an association between EPC numbers and the presence of traditional coronary artery disease (CAD) risk factors. The relationship between EPC numbers and the severity of atherosclerosis is, however, not known.
  
  
  METHODS
  EPC counts were measured by quantitative cell culture in 122 patients undergoing diagnostic cardiac catheterization. The association between patients' EPC count and the presence of multivessel CAD and traditional cardiac risk factors was assessed using logistic regression analysis.
  
  
  RESULTS
  The median age of the study population was 58 years; 37% had multivessel CAD, 29% had diabetes, and 14% had myocardial infarction this admission. EPC counts did not vary significantly with most established cardiac risk factors but were lower in diabetics versus nondiabetics and trended toward lower numbers in older patients. EPC count was the second strongest predictor of multivessel CAD, after patient age. Patients with multivessel disease had significantly lower EPC counts than those without (median, 3 vs 13; P < .0088). For every 10 colony forming unit increase in EPCs, a patient's likelihood for multivessel CAD declined by 20% (P < .001).
  
  
  CONCLUSIONS
  This study demonstrates an inverse relationship between circulating EPCs and CAD severity, independent of traditional risk factors. If confirmed in ongoing studies, this may represent an important new diagnostic and therapeutic target for coronary disease treatment.
authors.affiliation: Duke University Medical Center, Durham, NC 27710, USA. kunz0001@mc.duke.edu
authors.forename: Geoffrey A
authors.initials: GA
authors.lastname: Kunz
authors.forename: Ge
authors.initials: G
authors.lastname: Liang
authors.forename: Florim
authors.initials: F
authors.lastname: Cuculi
authors.forename: Florim
authors.initials: F
authors.lastname: Cuculoski
authors.forename: David
authors.initials: D
authors.lastname: Gregg
authors.forename: Korkut C
authors.initials: KC
authors.lastname: Vata
authors.forename: Linda K
authors.initials: LK
authors.lastname: Shaw
authors.forename: Pascal J
authors.initials: PJ
authors.lastname: Goldschmidt-Clermont
authors.forename: Chunming
authors.initials: C
authors.lastname: Dong
authors.forename: Doris A
authors.initials: DA
authors.lastname: Taylor
authors.forename: Eric D
authors.initials: ED
authors.lastname: Peterson
mesh_terms: D000368:Aged; D002478:Cells, Cultured; D003114:Colony-Forming Units Assay; D003324:Coronary Artery Disease / Q000097:blood* / Q000453:epidemiology / Q000473:pathology*; D003925:Diabetic Angiopathies / Q000097:blood / Q000453:epidemiology / Q000473:pathology; D004730:Endothelium, Vascular / Q000166:cytology*; D005260:Female; D006412:Hematopoietic Stem Cells / Q000378:metabolism*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012907:Smoking / Q000453:epidemiology / Q000378:metabolism