Document Detail

Endothelial progenitor cells, atheroma burden and clinical outcome in patients with coronary artery disease.
MedLine Citation:
PMID:  23390050     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: We wished to determine the effect of an acute coronary syndrome (ACS) on putative endothelial progenitor cell (EPC) populations, and define their relationship to coronary artery disease (CAD) severity and clinical outcome, in order to clarify their clinical relevance.
DESIGN AND SETTING: A prospective cohort study conducted in a tertiary referral cardiac centre.
PATIENTS: Two-hundred-and-one patients undergoing coronary angiography for suspected angina or ACS.
MAIN OUTCOME MEASURES: Putative EPC populations were determined by flow cytometry. CAD was quantified using the Gensini scoring system. Survival free from revascularisation, recurrent myocardial infarction and death were determined at 3 years.
RESULTS: Circulating CD34(+)VEGFR-2(+) and CD34(+)VEGFR-2(+)CD133(+) cells were rare (<0.007% of mononuclear cells), were not increased in patients with ACS, and were unrelated CAD severity or clinical outcome (p>0.1 for all). By contrast, CD34(+)CD45(-) cells were increased in patients with CAD compared with those with normal coronary arteries (p=0.008) and correlated with atheroma burden (r=0.44, p<0.001). Increased concentrations of circulating CD34(+)CD45(-) cells were associated with a shorter cumulative event-free survival (p<0.02). Proangiogenic monocytes (CD14(+)VEGFR-2(+)Tie-2(+)) and endothelial cell-colony forming units were increased in patients with ACS (p<0.01 for both), however, concentrations reflected myocardial necrosis, and did not predict the extent of CAD or clinical outcome.
CONCLUSIONS: Traditional EPC populations, CD34(+)VEGFR-2(+) and CD34(+)VEGFR-2(+)CD133(+) are not related to the extent of CAD or clinical outcome. However, CD34(+)CD45(-) cells are increased in patients with CAD and predict future cardiovascular events. It is likely that CD34(+)CD45(-) concentrations reflect the extent of vascular injury and atheroma burden.
Gareth J Padfield; Olga Tura-Ceide; Elizabeth Freyer; George Robin Barclay; Marc Turner; David E Newby; Nicholas L Mills
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2013-02-06
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  99     ISSN:  1468-201X     ISO Abbreviation:  Heart     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-03     Completed Date:  2013-09-24     Revised Date:  2014-02-20    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  England    
Other Details:
Languages:  eng     Pagination:  791-8     Citation Subset:  AIM; IM    
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MeSH Terms
Antigens, CD34 / immunology
Antigens, CD45 / immunology
Coronary Angiography
Coronary Artery Disease / diagnosis*,  immunology,  therapy
Coronary Vessels / immunology,  pathology*
Disease-Free Survival
Endothelium, Vascular / immunology,  metabolism,  pathology*
Flow Cytometry
Follow-Up Studies
Immunity, Cellular
Middle Aged
Myocardial Revascularization
Plaque, Atherosclerotic / diagnosis*,  immunology,  therapy
Prospective Studies
Severity of Illness Index
Stem Cells / immunology,  metabolism,  pathology*
Vascular Endothelial Growth Factor Receptor-2 / metabolism
Grant Support
FS/10/024/28266//British Heart Foundation; PG/07/017/22405//British Heart Foundation
Reg. No./Substance:
0/Antigens, CD34; EC Endothelial Growth Factor Receptor-2; EC, CD45

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