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Updated: May 1, 2026
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Early cardiac gene transcript levels in peripheral blood mononuclear cells reflect severity in stable coronary artery
Joanna E Kontaraki1, George E Kochiadakis, Maria E Marketou
1Department of Cardiology, Heraklion University Hospital, Heraklion, Crete, Greece.
Insights
Early cardiac gene transcripts in peripheral blood mononuclear cells (PBMCs) are elevated in patients with coronary artery disease (CAD). Higher levels of myocardin, GATA4, and Nkx2.5 correlate with increased CAD severity, offering a potential biomarker for disease progression.
Area of Science:
- Cardiovascular Biology
- Molecular Cardiology
- Genetics of Cardiovascular Disease
Background:
- Early cardiac marker genes, including myocardin, GATA4, and Nkx2.5, are crucial for cardiovascular development and implicated in adult cardiovascular disease.
- These genes play significant roles in both embryonic heart formation and the progression of adult cardiovascular pathologies.
Purpose of the Study:
- To evaluate the transcript levels of myocardin, GATA4, and Nkx2.5 in peripheral blood mononuclear cells (PBMCs) of patients with stable coronary artery disease (CAD).
- To examine the correlation between these gene transcript levels and the severity of CAD, as determined by the number of stenotic vessels.
Main Methods:
- Quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR) was employed to measure gene transcript levels.
- The study included 98 patients with stable CAD and 66 healthy controls, with CAD severity assessed via coronary angiography.
Main Results:
- Patients with 3-vessel CAD exhibited significantly elevated transcript levels of myocardin, GATA4, and Nkx2.5 compared to healthy controls.
- Transcript levels of myocardin and Nkx2.5 were also significantly higher in patients with 3-vessel CAD compared to those with 1-vessel CAD, indicating a dose-dependent relationship with disease severity.
Conclusions:
- Elevated early cardiac marker gene transcript levels in PBMCs of stable CAD patients suggest a potential non-invasive biomarker for disease severity.
- These findings indicate that changes in peripheral blood gene expression may reflect the extent of cardiovascular disease, possibly due to alterations in circulating cardiovascular progenitor cells.
Introduction:
The early cardiac marker genes myocardin, GATA4 and Nkx2.5, play a role in both embryonic cardiovascular development and adult cardiovascular disease. We evaluated transcript levels of myocardin, GATA4 and Nkx2.5 in peripheral blood mononuclear cells (PBMCs) in patients with stable coronary artery disease (CAD) and we examined the relationship between these levels and the severity of the disease, estimated by the number of stenotic vessels involved.
Methods:
Ninety-eight patients with stable CAD (age 66 ± 9 years) who underwent coronary angiography participated in the study; 66 healthy individuals (age 58 ± 13 years) were also included for comparison. Gene transcript levels were determined by quantitative real-time reverse transcription polymerase chain reaction.
Results:
Patients with 3-vessel CAD had elevated transcript levels of myocardin (median difference 2.7, p=0.001, 95% confidence interval, CI: 1-5.8), GATA4 (median difference 0.3, p=0.015, 95% CI: 0.1-1.9) and Nkx2.5 (median difference 16.1, p<0.001, 95% CI: 4.5-23) compared to healthy controls. Patients with 3-vessel CAD also showed elevated transcript levels of myocardin (median difference 2.3, p=0.001, 95% CI: 0.49-5.5) and Nkx2.5 (median difference 11.8, p<0.001, 95% CI: 1.5-21.5) compared to patients with 1-vessel CAD.
Conclusions:
Early cardiac marker gene transcript levels are significantly higher in the PBMCs of patients with severe stable CAD than in those of healthy controls, and show alterations in their expression profile according to the disease severity status. Our results indicate for the first time that changes in the early cardiac gene expression in the peripheral blood of stable CAD patients, possibly as a result of alterations in circulating cardiovascular progenitor cells that express these genes, may reflect the level of disease severity.
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