Circulating endothelial cells in coronary artery disease.
BACKGROUND
endothelial damage and dysfunction play a crucial role in the pathophysiology of coronary artery disease (CAD). The quantification of circulating endothelial cells (CEC) in the peripheral blood is a novel method for assessing endothelial damage.


OBJECTIVE
to evaluate the possible diagnostic use of single quantification of CEC in peripheral blood by flow cytometry in patients with CAD.


METHODS
we examined 48 patients with CAD, including 23 patients with acute myocardial infarction (AMI) and 25 patients with stable angina (SA). The control group consisted of 20 healthy subjects without symptoms of CAD. The CEC count was evaluated by flow cytometry using antibodies against CD31, CD146, and CD45. Plasma biochemical markers of endothelial damage (von Willebrand Factor [vWF], thrombomodulin [TM]) were measured by ELISA. Serum concentrations of troponin I (TnI) and lipid parameters were also included in the statistical analysis.


RESULTS
A significant increase in the CEC count was found in patients with AMI compared to the control group (p < 0.05) and SA patients (p < 0.05). However, no difference was found in the CEC count between patients with SA and the control group. Increased vWF activity was found in both groups of CAD patients compared to the control group (AMI: p < 0.001, SA: p , 0.01), and vWF activity was significantly higher in AMI patients compared to SA patients (p < 0.001). Thrombomodulin concentration did not differ significantly between any patient groups and the control group. The CEC count correlated positively with vWF activity (r = 0.3852, p < 0.05) and the atherogenic index TC/HDL-C (r = 0.3844, p < 0.05) in all patients with CAD (AMI + SA). The sensitivity of CEC count for the diagnosis of an acute coronary syndrome was lower than that of TnI level on admission (39% vs 69%).


CONCLUSIONS
we confirmed that CEC count in peripheral blood can be determined by flow cytometry in CAD patients with both AMI and SA. The CEC count in AMI was increased in comparison to healthy subjects and SA patients in one third of all cases. To determine whether CEC count could be used to improve the diagnosis of an acute coronary syndrome in patients with CAD, additional studies in larger patient groups would be required.
Department of Pathobiochemistry and Clinical Chemistry, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland. lampka@cm.umk.pl
Magdalena
M
Lampka
Zofia
Z
Grąbczewska
Ewa
E
Jendryczka-Maćkiewicz
Iga
I
Hołyńska-Iwan
Adam
A
Sukiennik
Jacek
J
Kubica
Waldemar
W
Halota
Tomasz
T
Tyrakowski
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000097:blood* / Q000473:pathology*; D015415:Biomarkers / Q000097:blood; D051929:CD146 Antigen / Q000097:blood; D003326:Coronary Circulation; D042783:Endothelial Cells / Q000473:pathology*; D004730:Endothelium, Vascular / Q000473:pathology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D017493:Leukocyte Common Antigens / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000473:pathology*; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000097:blood; D019210:Troponin I / Q000097:blood
D015415:Biomarkers; D051929:CD146 Antigen; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D019210:Troponin I; D017493:Leukocyte Common Antigens