title: The Kinetics of Circulating Monocyte Subsets and Monocyte-Platelet Aggregates in the Acute Phase of ST-Elevation Myocardial Infarction: Associations with 2-Year Cardiovascular Events.
abstract: In experimental myocardial infarction (MI), a rise in cell counts of circulating monocyte subsets contributes to impaired myocardial healing and to atherosclerotic plaque destabilization. In humans, the prognostic role of monocyte subsets in patients suffering ST-elevation MI (STEMI) is still unclear. In the present study, we aimed to determine the kinetics of the 3 monocyte subsets (classical CD14++CD16-, intermediate CD14++CD16+, and nonclassical CD14+CD16++ monocytes), as well as the subset-specific monocyte-platelet aggregates (MPA), in acute STEMI followed by primary percutaneous coronary intervention (PCI), and their relationships with cardiovascular outcomes during a 2-year follow-up.Monocyte subsets and MPA were measured in 100 STEMI patients receiving primary PCI on days 1, 2, 3, 5, and 7 of symptom onset, which were compared with 60 stable coronary heart disease patients and 35 healthy volunteers. From day 1 to day 7, significant increases in the counts of CD14++CD16+ monocytes and CD14++CD16+ MPA were observed, with peak levels on day 2. During a median follow-up of 2.0 years, 28 first cardiovascular events (defined as cardiovascular death, nonfatal ischemic stroke, recurrent MI, need for emergency or repeat revascularization, and rehospitalization for heart failure) were recorded. After adjustment for confounders, CD14++CD16+ monocytosis (day 1 [HR: 3.428; 95% CI: 1.597-7.358; P = 0.002], day 2 [HR: 4.835; 95% CI: 1.106-21.13; P = 0.04], day 3 [HR: 2.734; 95% CI: 1.138-6.564; P = 0.02], and day 7 [HR: 2.647; 95% CI: 1.196-5.861; P = 0.02]), as well as increased levels of CD14++CD16+ MPA measured on all time points (days 1, 2, 3, 5, and 7), had predictive values for adverse cardiovascular events.In conclusion, our data show the expansion of the CD14++CD16+ monocyte subset during acute phase of STEMI has predictive values for 2-year adverse cardiovascular outcomes in patients treated with primary PCI. Future studies will be warranted to elucidate whether CD14++CD16+ monocytes may become a target cell population for new therapeutic strategies after STEMI.
authors.affiliation: From the Tianjin Key Laboratory of Cardiovascular Remodeling and Target Organ Injury (XZ, X-LL, W-JJ, J-XL, Z-ZG, DR, Y-QM, SZ, Z-WX, H-XL, Y-ML), Pingjin Hospital Heart Center, Logistics University of Chinese People's Armed Police Forces, Tianjin, China; Division of Community Health and Humanities (PPW), Faculty of Medicine, Memorial University of Newfoundland, Newfoundland and Labrador, Canada; Department of Radiology (ZZ); Feinberg Cardiovascular Research Institute (BCB, DCL); Department of Pathology (EBT), Northwestern University Feinberg School of Medicine, Chicago, IL, USA; and Department of Internal Medicine IV (AMZ and GHH), Nephrology and Hypertension, Saarland University Medical Center, Homburg, Germany.
authors.forename: Xin
authors.initials: X
authors.lastname: Zhou
authors.forename: Xin-Lin
authors.initials: XL
authors.lastname: Liu
authors.forename: Wen-Jie
authors.initials: WJ
authors.lastname: Ji
authors.forename: Jun-Xiang
authors.initials: JX
authors.lastname: Liu
authors.forename: Zhao-Zeng
authors.initials: ZZ
authors.lastname: Guo
authors.forename: Dong
authors.initials: D
authors.lastname: Ren
authors.forename: Yong-Qiang
authors.initials: YQ
authors.lastname: Ma
authors.forename: Shan
authors.initials: S
authors.lastname: Zeng
authors.forename: Zhong-Wei
authors.initials: ZW
authors.lastname: Xu
authors.forename: Hong-Xia
authors.initials: HX
authors.lastname: Li
authors.forename: Peizhong Peter
authors.initials: PP
authors.lastname: Wang
authors.forename: Zhuoli
authors.initials: Z
authors.lastname: Zhang
authors.forename: Yu-Ming
authors.initials: YM
authors.lastname: Li
authors.forename: Brandon C
authors.initials: BC
authors.lastname: Benefield
authors.forename: Adam M
authors.initials: AM
authors.lastname: Zawada
authors.forename: Edward B
authors.initials: EB
authors.lastname: Thorp
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Lee
authors.forename: Gunnar H
authors.initials: GH
authors.lastname: Heine
mesh_terms: D000368:Aged; D015703:Antigens, CD / Q000032:analysis*; D001792:Blood Platelets / Q000378:metabolism*; D002449:Cell Aggregation; D002681:China; D017023:Coronary Angiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000145:classification / Q000378:metabolism; D010359:Patient Readmission / Q000706:statistics & numerical data; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods; D011184:Postoperative Period; D011237:Predictive Value of Tests; D012008:Recurrence; D012086:Reoperation / Q000706:statistics & numerical data; D000072657:ST Elevation Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000628:therapy
chemical_list: D015703:Antigens, CD