Endothelial progenitor cells, atheroma burden and clinical outcome in patients with coronary artery disease

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 (0.1 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.