Level and value of circulating endothelial progenitor cells in patients with acute myocardial infarction undergoing primary coronary angioplasty: in vivo and in vitro studies.
Levels of circulating endothelial progenitor cells (EPCs) in acute ST-elevation myocardial infarction (STEMI) patients undergoing primary coronary intervention (PCI) were investigated in this study. Flow cytometric analysis of the circulating EPC level (CD31/CD34 [E(1)], CD62E/CD34 [E(2)], and KDR/CD34 [E(3)]) was determined from blood samples of 161 consecutive patients with STEMI undergoing primary PCI. Angiogenesis was evaluated using mononuclear cell-derived EPCs on Matrigel. The EPC number (E(1-3)) was lower in STEMI patients than in normal subjects (n = 25) (P < 0.005). Patients with high EPCs (E(1-3)) (≥1.2%) had a lower left ventricular ejection fraction, elevated white blood cell count and creatinine level, advanced Killip score (≥class 3), more advanced congestive heart failure (CHF) (≥class 3), and increased 30-day mortality than those with a low EPC (E(1-3)) level (<1.2%) (P < 0.0001). Angiogenesis was lower in patients with a high EPC level than those with a low EPC level and normal controls (P < 0.001). Both the advanced Killip score and the CHF were independent predictors of increased EPC levels (P < 0.05). Multivariate analysis identified a high EPC (E(3)) level to be the most important predictor of increased 30-day major adverse clinical outcome (MACO) (P < 0.0001). In conclusion, the circulating EPC level is a major independent predictor of 30-day MACO in patients with STEMI undergoing primary PCI.
Chang
Hsueh-Wen
HW
Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.
Leu
Steve
S
Sun
Cheuk-Kwan
CK
Hang
Chi-Ling
CL
Youssef
Ali A
AA
Hsieh
Yuan-Kai
YK
Yang
Cheng-Hsu
CH
Cheng
Cheng-I
CI
Chen
Shyh-Ming
SM
Chen
Chien-Jen
CJ
Chua
Sarah
S
Chang
Li-Teh
LT
Wu
Chiung-Jen
CJ
Yip
Hon-Kan
HK
D000208:Acute Disease; D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D002465:Cell Movement; D049109:Cell Proliferation; D042783:Endothelial Cells / Q000166:cytology / Q000502:physiology*; D005260:Female; D005434:Flow Cytometry; D006333:Heart Failure; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000628:therapy; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D013234:Stem Cells / Q000166:cytology / Q000502:physiology*; D013318:Stroke Volume
D015415:Biomarkers