Circulating osteogenic endothelial progenitor cell counts: new biomarker for the severity of coronary artery disease.
BACKGROUND
There is increasing evidence implying that the early and functionally highly active circulating endothelial progenitor cell (CEPC) phenotype (CD34-/CD133+/KDR+) with osteogenic potential (OCN+) might link between vascular atherosclerotic calcification and mechanisms of bone metabolism. We sought to evaluate the early OCN+ CEPC counts as an independent biomarker for the severity of coronary artery disease (CAD).


METHODS
Peripheral blood samples were drawn from 593 patients undergoing clinically indicated coronary angiography. CAD severity was assessed by the presence of significant coronary artery stenosis (CAS) as well as an ordinal categorical variable. Subjects were followed for all-cause death over a median follow-up of 40months.


RESULTS
OCN+ early CEPC counts (square-root transformed) were independently associated with the presence of significant CAS [odds ratio (OR) per standard deviation (SD) increment: 1.389, 95% confidence interval [CI]: 1.131 to 1.707, p=0.002). Similar association was observed with an increase in levels of CAS (OR: 1.353, 95% CI: 1.157 to 1.582, p<0.001). There was a weak tendency between OCN+ early CEPC counts and all-cause mortality (p=0.090), whereas the highest decile of OCN+ early CEPC counts had a 2.991-fold increased risk of all-cause death (p=0.047).


CONCLUSIONS
We demonstrate for the first time an independent, significant, and strong correlation between OCN+ early CEPC counts and CAD severity. Additionally, very high numbers of OCN+ early CEPC tend to be linked to the risk of all-cause mortality.
Department of Cardiovascular Diseases, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA; 12(th) Ward, Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing 100029, China; Atherosclerosis Research Center, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing 100029, China; The Key Laboratory of Remodeling-related Cardiovascular Disease, Ministry of Education, Beijing 100029, China.
Shi-Wei
SW
Yang
Department of Cardiovascular Diseases, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA.
Rebecca R
RR
Hennessy
Department of Endocrinology, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA.
Sundeep
S
Khosla
Department of Biomedical Statistics, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA.
Ryan
R
Lennon
Department of Cardiovascular Diseases, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA.
Darrell
D
Loeffler
Department of Cardiovascular Diseases, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA.
Tao
T
Sun
Department of Cardiovascular Diseases, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA.
Zhi
Z
Liu
Department of Cardiovascular Diseases, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA.
Kyoung-Ha
KH
Park
Department of Cardiovascular Diseases, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA.
Fei-Long
FL
Wang
Department of Nephrology and Hypertension, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA.
Lilach O
LO
Lerman
Department of Cardiovascular Diseases, Mayo Clinic and College of Medicine, Rochester, MN 55905, USA. Electronic address: lerman.amir@mayo.edu.
Amir
A
Lerman
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging* / Q000401:mortality; D066026:Endothelial Progenitor Cells / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010012:Osteogenesis / Q000502:physiology*; D012720:Severity of Illness Index
D015415:Biomarkers
All-cause mortality; Circulating endothelial progenitor cells; Coronary artery disease severity; Osteocalcin