title: Differential levels of circulating progenitor cells in acute coronary syndrome patients with a first event versus patients with recurring events.
abstract: OBJECTIVE
  Pathophysiology of acute coronary syndromes in patients presenting with a first cardiac event (FCE) can be different from patients with a recurring cardiac event (RCE). We assessed inflammatory activation and circulating progenitor cells' (CPC) mobilisation in patients with a FCE versus those with RCE.
  
  
  METHODS
  We recruited 41 patients: 18 with FCE and 23 with RCE. Peripheral blood samples were drawn at baseline and at 20 days to measure high sensitivity C-reactive protein (CRP) and to assess CD34+/133+ CPC and CD34+/KDR+ CPC by flow cytometry.
  
  
  RESULTS
  CD34+/133+ cells (% number of cells per total number of cytometric events) were similar at baseline, being 0.25% (0.17-0.42%) in the FCE vs 0.23% (0.11-0.43%) in the RCE group, and increased at follow-up only in the FCE group to 0.41% (0.22-0.64%), while in the RCE group they were 0.27% (0.11-0.36%) (p=0.009 for the interaction, p=0.07 for the main effect of time). CD34+/KDR+ cells were similar at baseline in the two groups, did not significantly increase over time (p=0.2), and no differential effect of FCE vs RCE over time was seen (p=0.38). CRP levels, similar at baseline, were consistently reduced at 20 days after ACS (p=0.001), with no differential effect of FCE vs RCE pts (p=0.74). Variation from baseline to follow-up for both CD34+/133+ and CD34+/KDR+ did not correlate with either baseline CRP or delta CRP.
  
  
  CONCLUSIONS
  Our data demonstrate a differential CPC mobilization behavior for FCE patients compared to RCE ones, independent of inflammatory activation.
authors.affiliation: Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Rome, Italy. i.porto@doctors.org.uk
authors.forename: Italo
authors.initials: I
authors.lastname: Porto
authors.forename: Ilaria
authors.initials: I
authors.lastname: Dato
authors.forename: Luca
authors.initials: L
authors.lastname: Di Vito
authors.forename: Giovanni L
authors.initials: GL
authors.lastname: De Maria
authors.forename: Alessandra
authors.initials: A
authors.lastname: Tritarelli
authors.forename: Antonio M
authors.initials: AM
authors.lastname: Leone
authors.forename: Alessandra
authors.initials: A
authors.lastname: Paglia
authors.forename: Maurizio C
authors.initials: MC
authors.lastname: Capogrossi
authors.forename: Luigi M
authors.initials: LM
authors.lastname: Biasucci
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
mesh_terms: D000071916:AC133 Antigen; D054058:Acute Coronary Syndrome / Q000097:blood / Q000188:drug therapy / Q000473:pathology; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D015703:Antigens, CD / Q000378:metabolism; D018952:Antigens, CD34 / Q000378:metabolism; D001562:Benzimidazoles / Q000627:therapeutic use*; D001565:Benzoates / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry; D006023:Glycoproteins / Q000378:metabolism; D006412:Hematopoietic Stem Cells / Q000166:cytology* / Q000378:metabolism; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000378:metabolism; D011446:Prospective Studies; D017257:Ramipril / Q000627:therapeutic use*; D012008:Recurrence; D000077333:Telmisartan
chemical_list: D000071916:AC133 Antigen; D000806:Angiotensin-Converting Enzyme Inhibitors; D015703:Antigens, CD; D018952:Antigens, CD34; D001562:Benzimidazoles; D001565:Benzoates; D006023:Glycoproteins; D010455:Peptides; D002097:C-Reactive Protein; D017257:Ramipril; D000077333:Telmisartan