Reduced levels of putative endothelial progenitor and CXCR4+ cells in coronary artery disease: Kinetics following percutaneous coronary intervention and association with clinical characteristics

Abstract

SummaryLevels of circulating endothelial progenitor cells (EPCs) and CXCR4-positive cells are decreased in patients with coronary artery disease (CAD); however, their ability to change in response to acute vascular injury remains to be elucidated. Progenitor and CXCR4-positive cells were analysed by flow cytometry from the peripheral blood of 23 healthy controls and 23 patients with CAD, of which 13 patients underwent angiogram and 10 patients received percutaneous coronary intervention (PCI) with stent implantation. Baseline levels of progenitor and CXCR4-positive cells were substantially reduced in CAD patients compared to controls, although they were still capable of increasing in response to vascular injury. Levels of progenitor and CXCR4-positive cells were increased to a greater extent in the PCI group compared to angiogram patients. At presentation, levels of putative endothelial progenitor and CXCR4-positive cells were found to be negatively correlated with disease severity. A one-year follow-up revealed that out of the cell populations examined, only levels of CXCR4-positive cells were positively correlated with angina frequency in the PCI group, but not in patients receiving angiogram. Baseline levels of progenitor cells are differentially increased depending upon the severity of vascular injury incurred, regardless of a significant deficit in baseline levels in CAD patients. Levels of putative EPCs and CXCR4-positive cells were negatively correlated with disease severity at presentation, however, only CXCR4-positive cells were associated with patient condition in a one-year follow-up.

Pre-Procedural Atorvastatin Mobilizes Endothelial Progenitor Cells: Clues to the Salutary Effects of Statins on Healing of Stented Human Arteries

“…Similar to our data, they observed a 3-fold increase in cultured cells in the first 24 hours following PCI with the majority of their patients being concomitantly treated with statin medications. Finally, Egan et al [32] compared 10 patients undergoing PCI with 13 patients having angiogram only and found that CXCR4 positive cells were mobilized in response to PCI when compared to angiography alone. In contrast, our study looked at multiple time points out to two weeks after PCI in a total of 20 patients between both arms.…”

It Is All in the Blood: The Multifaceted Contribution of Circulating Progenitor Cells in Diabetic Complications

“…Importantly, EPCs are profoundly altered in the setting of type 1 and type 2 DM [20]. Several antigenic EPC phenotypes (e.g., CD34+KDR+) are profoundly reduced in the blood of type 2 diabetic patients compared to controls, independently of concomitant risk factors [21]. Pauperization of EPCs in diabetes is thought to explain, at least in part, the high CVD risk associated with DM, as patients would be less able to repair the endothelial injury and to counter ischemia with neoangiogenesis.…”

Large platelets but not putative endothelial progenitor cells are associated with low strut coverage after drug-eluting stent implantation

“…Thus, we could have missed the possible early rise of EPC within days after stent implantation [34]. Yet, another group has reported no increase of CD34 + cells after implantation of sirolimus-eluting stents measuring at various time points up to one month [35].…”