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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Prognostic value of circulating dead monocytes in patients with acute st-elevation myocardial infarction undergoing
Tzu-Hsien Tsai1, Yu-Chun Lin, Cheuk-Kwan Sun
1Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital - Kaohsiung Medical Center, Kaohsiung, Taiwan, ROC.
Objectives:
This study tested the hypothesis that the level of apoptotic and necrotic peripheral blood mononuclear cells (PBMCs) is a predictor of the 30-day combined major adverse clinical outcome (MACO) [defined as advanced congestive heart failure (CHF), a high Killip score, or 30-day mortality] in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI).
Methods:
Between April 2009 and January 2010, 98 patients undergoing primary PCI were assessed for both apoptotic and necrotic PBMCs (apoptotic cells are referred to as annexin V+/propidium iodide- and necrotic cells are defined as annexin V+/propidium iodide+) using flow cytometry 24 h after STEMI. Patients with higher (≥ 3.2%) and lower (<3.2%) levels of necrotic cells were categorized into group 1 (n = 40) and group 2 (n = 58), respectively, according to the ROC curve method.
Results:
Higher incidences of advanced CHF and a high Killip score were noted in group 1 patients (p < 0.0001). Moreover, the peak level of creatine phosphokinase was higher in group 1 (p < 0.0001), whereas the left ventricular ejection fraction was lower in group 1 than in group 2 (p < 0.001). Multivariate analysis revealed that high necrotic cells (≥ 3.2%) was the strongest independent predictor of 30-day MACO (p = 0.001).
Conclusion:
A high level of necrotic cells (PBMCs) may serve as a useful biomarker for predicting 30-day MACO in patients with STEMI undergoing primary PCI.
Insights
High levels of necrotic peripheral blood mononuclear cells (PBMCs) predict major adverse clinical outcomes within 30 days for ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). This finding offers a potential new biomarker for risk stratification.
Area of Science:
- Cardiology
- Immunology
- Biomarkers
Background:
- ST-elevation myocardial infarction (STEMI) is a critical cardiovascular event.
- Predicting 30-day major adverse clinical outcomes (MACO) after primary percutaneous coronary intervention (PCI) is crucial for patient management.
- Peripheral blood mononuclear cells (PBMCs) play a role in inflammatory responses post-STEMI.
Purpose of the Study:
- To investigate if apoptotic and necrotic PBMCs predict 30-day MACO in STEMI patients undergoing primary PCI.
- To determine the predictive value of necrotic PBMC levels for adverse outcomes.
- To identify potential biomarkers for risk stratification in STEMI patients.
Main Methods:
- Flow cytometry was used to assess apoptotic and necrotic PBMCs 24 hours after STEMI in 98 patients.
- Patients were categorized into high (≥ 3.2%) and low (<3.2%) necrotic PBMC groups.
- ROC curve analysis determined the cutoff for high necrotic cells.
Main Results:
- The high necrotic PBMC group showed significantly higher incidences of advanced congestive heart failure (CHF) and high Killip score (p < 0.0001).
- Higher peak creatine phosphokinase levels (p < 0.0001) and lower left ventricular ejection fraction (p < 0.001) were observed in the high necrotic PBMC group.
- Multivariate analysis identified high necrotic PBMCs (≥ 3.2%) as the strongest independent predictor of 30-day MACO (p = 0.001).
Conclusions:
- Elevated levels of necrotic PBMCs can serve as a valuable biomarker.
- This biomarker aids in predicting 30-day MACO in STEMI patients undergoing primary PCI.
- Necrotic PBMC levels offer a potential tool for early risk stratification and improved patient outcomes.
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