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Reduction of circulating endothelial progenitor cell level is associated with contrast-induced nephropathy in

Chia-Hung Chiang1, Po-Hsun Huang2, Chun-Chih Chiu3

  • 1Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu, Taiwan; Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan; Cardiovascular Research Center, National Yang-Ming University, Taipei, Taiwan.

Plos One
|March 21, 2014
PubMed

Insights

Reduced endothelial progenitor cells (EPCs) are linked to a higher risk of contrast-induced nephropathy (CIN) after angiography. Lower EPC levels predict CIN development and poorer cardiovascular outcomes in patients undergoing procedures.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Cell Biology

Background:

  • Endothelial progenitor cells (EPCs) are crucial for vascular repair.
  • Reduced EPC levels and function are observed in chronic kidney disease patients.
  • The association between EPC levels and contrast-induced nephropathy (CIN) risk is not well-established.

Purpose of the Study:

  • To investigate the relationship between circulating EPC levels and the risk of developing CIN in patients undergoing angiography.
  • To determine if EPC levels can predict CIN development and subsequent cardiovascular outcomes.

Main Methods:

  • Seventy-seven patients undergoing percutaneous coronary intervention (PCI) or transluminal angioplasty (PTA) were enrolled.
  • Peripheral blood samples were analyzed using flow cytometry to quantify EPC markers (CD34+, CD34+KDR+, CD34+KDR+CD133+).
  • CIN was defined as a significant increase in serum creatinine levels 48 hours post-procedure.

Main Results:

  • Eighteen patients (24%) developed CIN.
  • Patients who developed CIN had significantly lower circulating EPC levels (CD34+KDR+) compared to those without CIN (4.11±2.59 vs. 9.25±6.30 cells/105 events, P<0.001).
  • Lower EPC levels were a significant negative predictor for CIN development (OR 0.69, P=0.002), with the lowest EPC tertile showing a 52% CIN incidence.
  • CIN patients experienced a higher incidence of major adverse cardiovascular events over two years (66.7% vs. 25.4%, P=0.004).

Conclusions:

  • Decreased circulating EPC levels are associated with an increased risk of CIN.
  • Low EPC levels may contribute to CIN pathophysiology and predict poor prognosis.
  • EPC levels serve as a potential biomarker for CIN risk and cardiovascular outcomes post-angiography.
Abstract

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