Circulating endothelial cells in coronary artery disease
Magdalena Lampka1, Zofia Grąbczewska, Ewa Jendryczka-Maćkiewicz
1Department of Pathobiochemistry and Clinical Chemistry, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland. lampka@cm.umk.pl
Insights
Circulating endothelial cell (CEC) counts are elevated in acute myocardial infarction (AMI) patients, but not stable angina (SA) patients, compared to healthy individuals. Further research is needed to assess CECs for diagnosing acute coronary syndrome.
Area of Science:
- Cardiovascular Medicine
- Biomarker Discovery
- Diagnostic Imaging
Background:
- Endothelial damage and dysfunction are key in coronary artery disease (CAD) pathophysiology.
- Quantifying circulating endothelial cells (CECs) in peripheral blood offers a novel approach to assess endothelial damage.
Purpose of the Study:
- To evaluate the diagnostic utility of single CEC quantification in peripheral blood via flow cytometry for CAD patients.
- To compare CEC counts in patients with acute myocardial infarction (AMI) and stable angina (SA) against healthy controls.
Main Methods:
- Flow cytometry was used to quantify CECs (CD31, CD146, CD45 antibodies) in 48 CAD patients (23 AMI, 25 SA) and 20 controls.
- Plasma von Willebrand Factor (vWF) and thrombomodulin (TM) were measured by ELISA.
- Serum troponin I (TnI) and lipid parameters were analyzed.
Main Results:
- CEC counts were significantly higher in AMI patients versus controls (p < 0.05) and SA patients (p < 0.05).
- No significant difference in CEC counts was observed between SA patients and controls.
- CEC count correlated positively with vWF activity (r = 0.3852) and the TC/HDL-C atherogenic index (r = 0.3844) in all CAD patients.
Conclusions:
- CEC quantification by flow cytometry is feasible in CAD patients (AMI and SA).
- Elevated CEC counts were observed in one-third of AMI patients compared to controls and SA patients.
- Additional studies with larger cohorts are necessary to determine if CEC counts can enhance acute coronary syndrome diagnosis.
Background:
endothelial damage and dysfunction play a crucial role in the pathophysiology of coronary artery disease (CAD). The quantification of circulating endothelial cells (CEC) in the peripheral blood is a novel method for assessing endothelial damage.
Aim:
to evaluate the possible diagnostic use of single quantification of CEC in peripheral blood by flow cytometry in patients with CAD.
Methods:
we examined 48 patients with CAD, including 23 patients with acute myocardial infarction (AMI) and 25 patients with stable angina (SA). The control group consisted of 20 healthy subjects without symptoms of CAD. The CEC count was evaluated by flow cytometry using antibodies against CD31, CD146, and CD45. Plasma biochemical markers of endothelial damage (von Willebrand Factor [vWF], thrombomodulin [TM]) were measured by ELISA. Serum concentrations of troponin I (TnI) and lipid parameters were also included in the statistical analysis.
Results:
A significant increase in the CEC count was found in patients with AMI compared to the control group (p < 0.05) and SA patients (p < 0.05). However, no difference was found in the CEC count between patients with SA and the control group. Increased vWF activity was found in both groups of CAD patients compared to the control group (AMI: p < 0.001, SA: p , 0.01), and vWF activity was significantly higher in AMI patients compared to SA patients (p < 0.001). Thrombomodulin concentration did not differ significantly between any patient groups and the control group. The CEC count correlated positively with vWF activity (r = 0.3852, p < 0.05) and the atherogenic index TC/HDL-C (r = 0.3844, p < 0.05) in all patients with CAD (AMI + SA). The sensitivity of CEC count for the diagnosis of an acute coronary syndrome was lower than that of TnI level on admission (39% vs 69%).
Conclusions:
we confirmed that CEC count in peripheral blood can be determined by flow cytometry in CAD patients with both AMI and SA. The CEC count in AMI was increased in comparison to healthy subjects and SA patients in one third of all cases. To determine whether CEC count could be used to improve the diagnosis of an acute coronary syndrome in patients with CAD, additional studies in larger patient groups would be required.
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