Circulating endothelial progenitor cells and clinical outcome in patients with congestive heart failure.
BACKGROUND
Circulating endothelial progenitor cells (EPCs) are increased in conditions associated with ischaemia and can potentially support angiogenesis and vasculogenesis. EPC levels were also shown to predict outcome in patients with atherosclerotic vascular disease. We tested the hypothesis that circulating EPC can predict outcome in patients with congestive heart failure (CHF).


METHODS
EPC-colony-forming units were measured in the peripheral blood of 107 consecutive patients with CHF with New York Heart Association (NYHA) functional class II-IV. Serum levels of vascular endothelial growth factor (VEGF), N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) and high-sensitivity C-reactive protein (hsCRP) were also measured. End points were defined as CHF-related hospital admissions and all-cause mortality.


RESULTS
Age (p = 0.01), diabetes mellitus (p = 0.002) and EPC levels (p = 0.02) were found to be independent predictors of all-cause mortality. EPC levels did not predict CHF-related hospitalisations. EPC levels correlated positively with NYHA (p = 0.05, r = 0.19), but did not correlate with VEGF, NT-pro-BNP or hsCRP. EPC levels did not differ by the aetiology of CHF.


CONCLUSIONS
EPC levels are independent predictors of all-cause mortality among patients with CHF.
Michowitz
Yoav
Y
The Department of Cardiology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.
Goldstein
Emil
E
Wexler
Dov
D
Sheps
David
D
Keren
Gad
G
George
Jacob
J
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D003114:Colony-Forming Units Assay; D042783:Endothelial Cells / Q000502:physiology*; D004730:Endothelium, Vascular / Q000473:pathology; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000473:pathology; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011379:Prognosis; D012307:Risk Factors; D013234:Stem Cells / Q000502:physiology*; D016019:Survival Analysis; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
D015415:Biomarkers; D010446:Peptide Fragments; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein