Abstract 2278: Factors Associated with the Levels of Circulating Endothelial Progenitor Cells in Patients with Acute, Subacute and Chronic stroke.

Abstract

Introduction In patients with ischemic stroke, the levels of circulating Endothelial Progenitor Cells (EPCs) have been infrequently studied. Our study was focused on investigating the EPC counts in patients with acute, subacute and chronic ischemic stroke and analyzing the associated variables. Methods We prospectively studied consecutive patients with ischemic stroke within the first 48 hours from symptoms onset. We evaluated demographic data (age, sex); classical vascular risk factors (high blood pressure, diabetes mellitus, hypercholesterolemia, coronary artery disease, peripheral vascular disease, previous ischemic stroke, smoking, alcohol abuse, obesity, number or risk factors); thrombolysis; treatment with statins before and after stroke; etiology (sss-TOAST criteria); severity of the neurological deficit (NIHSS score). Blood samples were collected at baseline (n=146), day 7 (n=121) and day 90 (n=92) after stroke onset. EPCs were measured by flow cytometry within 30 minutes after blood collection. We considered that a cell was an EPC when it was labeled for the following 3 markers: CD34, AC133 and KDR. EPC counts were adjusted for the lymphomonocytic population in each sample and expressed as %. Statistics: Non-parametric bivariate analyses, logistic regression analysis. Results We included 146 patients (mean age 70.8±12.2 y, 63% men). In the baseline sample, the following variables were associated with the EPCs count: alcohol abuse (p=0.08), hipercolesterolemia (p=0.029), pre-treatment with statins (p=0.015) and etiology (p=0.037). There were no variables associated with the EPCs count at 7 days. Variables associated with the EPCs count at 3 months were: treatment with statins after stroke (p=0.017), old cerebral infarction (p=0.059) and obesity (p=0.029). The multivariate analysis showed that pre-treatment with statins (OD 3.11, 95%CI 1.34-7.19, p=0.008) and stroke of unknown etiology (p=0.032) independently predicted higher EPC counts at baseline. No variables were independently associated with EPCs counts at 7 days. Finally, at day 90, treatment with statins after stroke was the only variable independently associated with higher EPC counts (OR 11.7, 95%CI 1.5-86, p=0.016). Conclusion In conclusion, prior treatment with statins and stroke etiology are predictors of EPC counts in patients with acute ischemic stroke, while treatment with statins after stroke is independently associated with EPC count at 3 months. The increase in EPCs may be one of the pleiotropic effects of statins that improve the outcome of patients with ischemic stroke.