title: Endothelial progenitor cells in acute ischemic stroke.
abstract: OBJECTIVE
  The levels of circulating endothelial progenitor cells (EPCs) in ischemic stroke have not been studied extensively and reported results are inconsistent. We aimed to investigate the time course, the prognostic relevance, and the variables associated with EPC counts in patients with ischemic stroke at different time points.
  
  
  METHODS
  We studied prospectively 146 consecutive patients with ischemic stroke within the first 48 h from the onset of symptoms (baseline). We evaluated demographic data, classical vascular risk factors, treatment with thrombolysis and statins, stroke etiology, National Institute of Health and Stroke Scale score and outcome (favorable when Rankin scale score 0-2). Blood samples were collected at baseline, at day 7 after stroke (n = 121) and at 3 months (n = 92). The EPC were measured by flow cytometry.
  
  
  RESULTS
  We included 146 patients with a mean age of 70.8 ± 12.2 years. The circulating EPC levels were higher on day 7 than at baseline or at 3 months (P = 0.045). Pretreatment with statins (odds ratio [OR] 3.11, P = 0.008) and stroke etiology (P = 0.032) were predictive of EPC counts in the baseline sample. EPC counts were not associated with stroke severity or functional outcome in all the patients. However, using multivariate analyses, a better functional outcome was found in patients with higher EPC counts in large-artery atherosclerosis and small-vessel disease etiologic subtypes.
  
  
  CONCLUSIONS
  After acute ischemic stroke, circulating EPC counts peaked at day 7. Pretreatment with statins increased the levels of EPC. In patients with large-artery atherosclerosis and small-vessel disease subtypes, higher counts were related to better outcome at 3 months.
authors.affiliation: Department of Neurology, IIB Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau 08025, Barcelona, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Martí-Fàbregas
authors.affiliation: Cardiovascular Research Center, IIB-Sant Pau Avda Sant Antoni M.Claret, 167, 08025, Barcelona, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Crespo
authors.affiliation: Department of Neurology, IIB Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau 08025, Barcelona, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Delgado-Mederos
authors.affiliation: Department of Neurology, IIB Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau 08025, Barcelona, Spain.
authors.forename: Sergi
authors.initials: S
authors.lastname: Martínez-Ramírez
authors.affiliation: Cardiovascular Research Center, IIB-Sant Pau Avda Sant Antoni M.Claret, 167, 08025, Barcelona, Spain.
authors.forename: Esther
authors.initials: E
authors.lastname: Peña
authors.affiliation: Department of Neurology, IIB Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau 08025, Barcelona, Spain.
authors.forename: Rebeca
authors.initials: R
authors.lastname: Marín
authors.affiliation: Department of Neurology, IIB Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau 08025, Barcelona, Spain.
authors.forename: Lavinia
authors.initials: L
authors.lastname: Dinia
authors.affiliation: Department of Neurology, IIB Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau 08025, Barcelona, Spain.
authors.forename: Elena
authors.initials: E
authors.lastname: Jiménez-Xarrié
authors.affiliation: Department of Neurology, IIB Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau 08025, Barcelona, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: Fernández-Arcos
authors.affiliation: Department of Neurology, IIB Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau 08025, Barcelona, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: Pérez-Pérez
authors.affiliation: Department of Neurology, IIB Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau 08025, Barcelona, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Querol
authors.affiliation: Department of Neurology, IIB Biomedical Research Institute, Hospital de la Santa Creu i Sant Pau 08025, Barcelona, Spain.
authors.forename: Marc
authors.initials: M
authors.lastname: Suárez-Calvet
authors.affiliation: Cardiovascular Research Center, IIB-Sant Pau Avda Sant Antoni M.Claret, 167, 08025, Barcelona, Spain.
authors.forename: Lina
authors.initials: L
authors.lastname: Badimon
keywords: Endothelial progenitor cells; ischemic stroke; statin