title: Endothelial progenitor cells predict long-term prognosis in patients with stable angina treated with percutaneous coronary intervention: five-year follow-up of the PROCREATION study.
abstract: BACKGROUND
  The association between endothelial progenitor cells (EPCs) at the time of percutaneous coronary intervention (PCI) and the subsequent long-term clinical outcome remains undefined. To address this issue, a pre-specified analysis of the PROgenitor Cells role in Restenosis and progression of coronary ATherosclerosis after percutaneous coronary intervention (PROCREATION) study was done.
  
  
  RESULTS
  A total of 155 patients with stable angina treated with PCI had flow cytometry before PCI. Patients had a 5-year follow-up. Primary outcome was the composite of major adverse cardiac or cerebrovascular events (MACCE), that is, death, stroke, myocardial infarction, and revascularization. During follow-up, MACCE occurred in 65 of 155 patients (42%). There were no significant differences in clinical and angiographic variables between patients with or without MACCE, apart from a different extent of coronary atherosclerosis. The incidence of MACCE increased significantly over tertiles of CD34+/KDR+/CD45- cells and CD133+/KDR+/CD45- cells, with rates of 25%, 39%, and 69% (P=0.0001), and 26%, 44%, and 59% (P=0.003), respectively. On multivariate analysis it was estimated that the increase in CD34+/KDR+/CD45- cells was associated with a 35% higher risk for MACCE (hazard ratio [HR], 1.75; 95% confidence interval [CI]: 1.07-1.99; P=0.001), and the increase in CD133+/KDR+/CD45- cells was associated with a 25% higher risk for MACCE (HR, 1.35; 95% CI: 1.01-1.74; P=0.03).
  
  
  CONCLUSIONS
  Assessment of subpopulations of circulating EPCs in patients with stable angina treated with PCI can improve characterization of long-term prognosis (ClinicalTrials.gov: NCT01575431).
authors.affiliation: Department of Cardiology, Sapienza University, Rome, Italy. f.pelliccia@mclink.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Pelliccia
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Pasceri
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rosano
authors.forename: Christian
authors.initials: C
authors.lastname: Pristipino
authors.forename: Adriana
authors.initials: A
authors.lastname: Roncella
authors.forename: Giulio
authors.initials: G
authors.lastname: Speciale
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Pannarale
authors.forename: Michele
authors.initials: M
authors.lastname: Schiariti
authors.forename: Cesare
authors.initials: C
authors.lastname: Greco
authors.forename: Carlo
authors.initials: C
authors.lastname: Gaudio
mesh_terms: D000368:Aged; D060050:Angina, Stable / Q000097:blood / Q000401:mortality / Q000628:therapy; D000943:Antigens, Differentiation / Q000097:blood*; D018572:Disease-Free Survival; D042783:Endothelial Cells / Q000378:metabolism*; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011183:Postoperative Complications / Q000097:blood / Q000401:mortality; D011237:Predictive Value of Tests; D012307:Risk Factors; D013234:Stem Cells / Q000378:metabolism*; D015996:Survival Rate; D013997:Time Factors
chemical_list: D000943:Antigens, Differentiation