title: Endothelial progenitor cells are suppressed in anemic patients with acute coronary syndrome.
abstract: OBJECTIVE
  Anemia is an independent predictor of poor prognosis in acute coronary syndrome. Endothelial progenitor cells are bone marrow-derived cells that are mobilized into the circulation in response to ischemia. The number of circulating endothelial progenitor cells increases within days of acute coronary syndrome. There is no confirmation regarding the correlation between the occurrence of anemia and the deficiency in endothelial progenitor cells in patients with acute coronary syndrome. The correlation between chronic anemia and endothelial progenitor cells in patients with acute coronary syndrome was investigated.
  
  
  METHODS
  Endothelial progenitor cells were examined in 26 patients with acute coronary syndrome. Fifteen patients had chronic nonprogressive anemia, and 11 patients had a normal blood count. Blood samples were drawn on the first day of admission and 4 to 7 days later. Mononuclear cells were separated and cultured on fibronectin-coated plates with EndoCult medium (StemCell Technologies, Vancouver, BC, Canada) for 5 days. Colony forming unit count and a migration assay were performed at each time point.
  
  
  RESULTS
  Baseline colony forming unit in the non-anemic group was higher than in the anemic group (P<.0001). There was a highly significant correlation between admission hemoglobin and colony forming unit count (R=0.83, P<.0001). Colony forming units increased in both groups on the second measurement but to a lower extent in the anemic group (P = .0004). The migration assay in the non-anemic group was higher than in the anemic group at baseline (P = .017) and 4 to 7 days later (P = .0054).
  
  
  CONCLUSIONS
  Patients with acute coronary syndrome with anemia demonstrate a reduced number of peripheral endothelial progenitor cells with impaired function, possibly representing a lower capacity for vascular healing. These phenomena may partly explain the poor prognosis observed in patients with acute coronary syndrome and anemia.
authors.affiliation: Research Laboratory, Cardiovascular Division, Baruch-Padeh Poria Medical Center, Tiberias, Israel.
authors.forename: Aya
authors.initials: A
authors.lastname: Solomon
authors.forename: Arnon
authors.initials: A
authors.lastname: Blum
authors.forename: Aviva
authors.initials: A
authors.lastname: Peleg
authors.forename: Eli I
authors.initials: EI
authors.lastname: Lev
authors.forename: Dorit
authors.initials: D
authors.lastname: Leshem-Lev
authors.forename: Yonathan
authors.initials: Y
authors.lastname: Hasin
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D000328:Adult; D000367:Age Factors; D000368:Aged; D000741:Anemia, Aplastic / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D001853:Bone Marrow / Q000503:physiopathology*; D016022:Case-Control Studies; D002465:Cell Movement; D002908:Chronic Disease; D004311:Double-Blind Method; D005260:Female; D006412:Hematopoietic Stem Cells / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D018401:Sample Size; D012737:Sex Factors