Abstract 17749: Circulating Progenitor Cell Enriched Populations are Predictors of Coronary Artery Disease Burden and Adverse Long Term Outcomes
Background: We hypothesized that circulating cells expressing progenitor cell markers, that may represent intrinsic regenerative/reparative potential would predict angiographically defined coronary artery disease (CAD) presence, severity and future adverse outcomes.
Methods: We studied 466 patients undergoing coronary angiography (age 64 ± 11 years, male 67 %) and measured the frequency of circulating mononuclear cells expressing CD34, CD133 and KDR surface markers. Angiographic CAD burden was estimated using the Gensini score. Patients were followed for “major events”, a composite of death and MI and “all events” which includes coronary revascularization.
Results: When compared to patients with normal coronary arteries, those with angiographic CAD (>50% stenosis) had significantly lower CD34+ (1.5 ± 0.5 v 1.2 ± 0.5, p=0.02) and CD34+/CD133+ (0.8 ± 0.4 v 0.6 ± 0.4, p=0.002) cell counts per ul. There was an inverse relationship between CAD severity (Gensini) and both CD34+ (r=−0.13, p=0.01) and CD34+/133+ (r=−0.18, p<0.001) cells, (Figure A), even after adjustment for age, gender, risk factors, prior MI and medications (p=0.01, p=0.002 respectively). After a median follow up of 1.4 years, patients with a low CD34+ count (<0.81/ul by ROC) or a low CD34+/CD133+ count (<0.48/ul by ROC) had a worse prognosis compared to those with higher counts for the composite end point of death/MI (log rank p=0.006, p<0.001 respectively) (Figure B). After adjustment for the above covariates and CAD severity, low CD34+ and CD34+/133+ cell counts were predictive of major (HR of 3.2 (1.4 – 7.2); HR 3.9 (1.6 – 9.2)) and all events (HR 2.0 (1.2 – 3.6); HR 2.3 (1.3 – 4.2) respectively).
Conclusions: Baseline CD34+ and CD34+/133+ cell counts are (1) lower in subjects with CAD (2) correlate inversely with coronary atherosclerotic burden and (3) are predictive of future adverse events. Markers of regenerative capacity appear to independently predict cardiovascular disease and outcomes.
- Progenitor cell
- Endothelial progenitor cell
- Coronary artery disease
- Stem cell and atherosclerosis
- © 2010 by American Heart Association, Inc.