title: Vascular Health Profile predicts cardiovascular outcomes in patients with diabetes.
abstract: We previously reported the development of a novel high dimensional cytomic assay, the Vascular Health Profile (VHP) based on measurements of angiogenic circulating hematopoietic stem and progenitor cells (CHSPCAng) and extracellular vesicles (EVs), that discovered a unique signature, differentiating the vascular status of diabetics and normal healthy controls. Here, we present data from a 3-year follow-up to evaluate the power of the VHP to identify individuals at risk for cardiovascular (CV) events.
  
  
  
  The original data were generated as previously described by measuring a broad panel of progenitor cells and EVs and profiled using cytometric fingerprinting. Subjects were classified into groups according to the occurrence of adjudicated CV events including myocardial infarction, stroke, major adverse cardiovascular events, revascularization, and irregular rhythm. Cross-validated Linear Discriminate Analysis (LDA) models were constructed and used to predict the occurrence of events, and were evaluated for predictive accuracy (AUC, area under the curve) using receiver operating characteristic (ROC) analysis.
  
  
  
  Over the period of this analysis, follow-up data was obtained on 87 subjects, with 32 events occurring overall, and only in the diabetic group. In all cases, the VHP added significant predictive power, in the form of ROC analysis, for all evaluated outcomes with the exception of irregular rhythm.
  
  
  
  The VHP, a relatively simple blood test, can provide sensitive and clinically relevant information on the vascular status of a patient that may be useful for a variety of applications including drug development, clinical risk assessment, and companion diagnostics. © 2015 International Clinical Cytometry Society.
authors.affiliation: Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Wade T
authors.initials: WT
authors.lastname: Rogers
authors.affiliation: Section of Vascular Medicine, Division of Cardiovascular Disease, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Lifeng
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Section of Vascular Medicine, Division of Cardiovascular Disease, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Scott
authors.initials: S
authors.lastname: Welden
authors.affiliation: Section of Vascular Medicine, Division of Cardiovascular Disease, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Krieger
authors.affiliation: Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Michael
authors.initials: M
authors.lastname: Rickels
authors.affiliation: Department of Pathology and Laboratory Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Jonni S
authors.initials: JS
authors.lastname: Moore
authors.affiliation: Section of Vascular Medicine, Division of Cardiovascular Disease, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Emile R
authors.initials: ER
authors.lastname: Mohler
mesh_terms: D000368:Aged; D001145:Arrhythmias, Cardiac / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D050197:Atherosclerosis / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D000067128:Extracellular Vesicles / Q000737:chemistry / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D055442:Metabolome; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D009204:Myocardial Revascularization / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D013234:Stem Cells / Q000378:metabolism* / Q000473:pathology; D020521:Stroke / Q000097:blood / Q000150:complications / Q000175:diagnosis*
keywords: atherosclerosis; diabetes mellitus; extracellular vesicle; microparticle; myocardial infarction; progenitor cell; revascularization; stroke