The association between circulating endothelial progenitor cells and outcome in different subtypes of acute ischemic stroke.
OBJECTIVE
This study evaluated the relationship between serial changes in circulating endothelial progenitor cells (EPCs) and outcomes in patients with different subtypes of acute ischemic stroke (AIS).


METHODS
This prospective cohort study evaluated 65 patients with AIS, including 45 with small-vessel and 20 with large-vessel diseases. The circulating level of EPCs (CD133(+)/CD34(+) and KDR(+)/CD34(+) cells) was determined at different time points (within 48h and on Days 7 and 30 post-stroke). For comparison, the EPC levels of 65 age- and sex-matched controls were also evaluated.


RESULTS
The levels of CD133(+)/CD34(+) and KDR(+)/CD34(+) EPCs were significantly lower in the AIS group than in the control group (p<0.05). There were fewer CD133(+)/CD34(+) EPCs in the large-vessel disease group than in the small-vessel disease group on Day 1 post-stroke (p<0.05). After adjusting for covariance using stepwise logistic regression, only stroke subtype (OR: 30.2, 95% CI: 5.3-171.4; p<0.001) and KDR(+)/CD34(+) on admission (OR: 0.188, 95% CI: 0.04-0.86; p=0.031) were independently associated with 6-month outcome.


CONCLUSIONS
The number of circulating EPCs is significantly lower in patients with large-vessel disease than in those with small-vessel disease. Fewer number of EPCs on admission is an independent risk factor for poor 6-month outcome in patients with AIS.
Department of Neurology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Taiwan.
Nai-Wen
NW
Tsai
Shu-Hua
SH
Hung
Chi-Ren
CR
Huang
Hsueh-Wen
HW
Chang
Wen-Neng
WN
Chang
Lian-Hui
LH
Lee
Hung-Chen
HC
Wang
Yu-Jun
YJ
Lin
Wei-Che
WC
Lin
Ben-Chung
BC
Cheng
Yi-Fang
YF
Chiang
Yu-Jih
YJ
Su
Tong-Rong
TR
Tsai
Cheng-Hsien
CH
Lu
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000097:blood* / Q000145:classification / Q000175:diagnosis*; D015331:Cohort Studies; D042783:Endothelial Cells / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D013234:Stem Cells / Q000378:metabolism* / Q000473:pathology; D020521:Stroke / Q000097:blood* / Q000145:classification / Q000175:diagnosis*; D055815:Young Adult
Acute ischemic stroke; Endothelial progenitor cells; Large vessel disease; Outcome; Small vessel disease