title: Predictive value of the decrease in circulating dendritic cell precursors in stable coronary artery disease.
abstract: DCs (dendritic cells) are present in atherosclerotic lesions leading to vascular inflammation, and the number of vascular DCs increases during atherosclerosis. Previously, we have shown that the levels of circulating DCPs (DC precursors) are reduced in acute coronary syndromes through vascular recruitment. In the present study, we have investigated whether DCP levels are also reduced in stable CAD (coronary artery disease). The levels of circulating mDCPs (myeloid DCPs), pDCPs (plasmacytoid DCPs) and tDCP (total DCPs) were investigated using flow cytometry in 290 patients with suspected stable CAD. A coronary angiogram was used to evaluate a CAD score for each patient as follows: (i) CAD excluded (n=57); (ii) early CAD (n=63); (iii) moderate CAD (n=85); and (iv) advanced CAD (n=85). Compared with controls, patients with advanced stable CAD had lower HDL (high-density lipoprotein)-cholesterol (P=0.03) and higher creatinine (P=0.003). In advanced CAD, a significant decrease in circulating mDCPs, pDCPs and tDCPs was observed (each P<0.001). A significant inverse correlation was observed between the CAD score and mDCPs, pDCPs or tDCPs (each P<0.001). Patients who required percutaneous coronary intervention or coronary artery bypass grafting had less circulating mDCPs, pDCPs and tDCPs than controls (each P<0.001). Multiple stepwise logistic regression analysis suggested mDCPs, pDCPs and tDCPs as independent predictors of CAD. In conclusion, we have shown that patients with stable CAD have significantly lower levels of circulating DCPs than healthy individuals. Their decrease appears to be an independent predictor of the presence of, and subsequent therapeutic procedure in, stable CAD.
authors.affiliation: Medical Clinic II, University Hospital of Erlangen, Erlangen, Germany. A.Yilmaz@web.de
authors.forename: Atilla
authors.initials: A
authors.lastname: Yilmaz
authors.forename: Tina
authors.initials: T
authors.lastname: Schaller
authors.forename: Iwona
authors.initials: I
authors.lastname: Cicha
authors.forename: Regina
authors.initials: R
authors.lastname: Altendorf
authors.forename: Christian
authors.initials: C
authors.lastname: Stumpf
authors.forename: Lutz
authors.initials: L
authors.lastname: Klinghammer
authors.forename: Josef
authors.initials: J
authors.lastname: Ludwig
authors.forename: Werner G
authors.initials: WG
authors.lastname: Daniel
authors.forename: Christoph D
authors.initials: CD
authors.lastname: Garlichs
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D002317:Cardiovascular Agents / Q000627:therapeutic use; D002452:Cell Count; D008076:Cholesterol, HDL / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D003713:Dendritic Cells / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012720:Severity of Illness Index; D013234:Stem Cells / Q000473:pathology*
chemical_list: D015415:Biomarkers; D002317:Cardiovascular Agents; D008076:Cholesterol, HDL; D002097:C-Reactive Protein