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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
The relationship between endothelial progenitor cell populations and epicardial and microvascular coronary disease-a
Kim H Chan1, Philippa J L Simpson2, Andy S Yong3
1Department of Cardiology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia; The Heart Research Institute, Sydney, New South Wales, Australia; Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.
Insights
Late outgrowth endothelial cells (OECs) correlate with coronary artery disease (CAD) severity, unlike early endothelial progenitor cells (EPCs). OEC function, not number, impacts microvascular function in CAD patients.
Area of Science:
- Cardiovascular Research
- Stem Cell Biology
- Vascular Medicine
Background:
- Endothelial progenitor cells (EPCs) play a role in vascular health, but their association with coronary artery disease (CAD) severity and microcirculation remains unclear.
- Previous studies show conflicting results regarding EPCs and epicardial CAD, and the role of different EPC types in microvascular function is unknown.
Purpose of the Study:
- To investigate the relationship between distinct EPC populations (early EPCs and OECs) and the severity of both epicardial and microvascular coronary artery disease.
- To determine if EPC number and function correlate with physiological measures of coronary artery disease.
Main Methods:
- Studied 33 patients with isolated left anterior descending artery disease.
- Physiologically assessed epicardial and microvascular coronary function using fractional flow reserve (FFR), index of microvascular resistance (IMR), and coronary flow reserve (CFR).
- Isolated and analyzed two EPC populations (early EPCs and late outgrowth endothelial cells [OECs]) ex vivo for number and function (migration, tubulogenesis).
Main Results:
- Circulating OEC levels inversely correlated with epicardial CAD severity (FFR and angiography).
- More severe CAD was linked to impaired OEC migration and tubulogenesis, with lower OEC levels and function in patients with significant stenoses (FFR<0.75).
- No significant relationship was found between early EPCs and CAD severity or microvascular resistance (IMR); however, OEC function correlated with coronary flow reserve (CFR).
Conclusions:
- Distinct EPC populations exhibit different associations with CAD severity.
- OEC number and function, but not early EPCs, significantly correlate with epicardial CAD.
- EPCs, including OECs, did not show a relationship with the severity of coronary microvascular disease.
Background:
Endothelial progenitor cells (EPCs) are implicated in protection against vascular disease. However, studies using angiography alone have reported conflicting results when relating EPCs to epicardial coronary artery disease (CAD) severity. Moreover, the relationship between different EPC types and the coronary microcirculation is unknown. We therefore investigated the relationship between EPC populations and coronary epicardial and microvascular disease.
Methods:
Thirty-three patients with a spectrum of isolated left anterior descending artery disease were studied. The coronary epicardial and microcirculation were physiologically interrogated by measurement of fractional flow reserve (FFR), index of microvascular resistance (IMR) and coronary flow reserve (CFR). Two distinct EPC populations (early EPC and late outgrowth endothelial cells [OECs]) were isolated from these patients and studied ex vivo.
Results:
There was a significant inverse relationship between circulating OEC levels and epicardial CAD severity, as assessed by FFR and angiography (r=0.371, p=0.04; r=-0.358, p=0.04; respectively). More severe epicardial CAD was associated with impaired OEC migration and tubulogenesis (r=0.59, p=0.005; r=0.589, p=0.004; respectively). Patients with significant epicardial CAD (FFR<0.75) had lower OEC levels and function compared to those without hemodynamically significant stenoses (p<0.05). In contrast, no such relationship was seen for early EPC number and function, nor was there a relationship between IMR and EPCs. There was a significant relationship between CFR and OEC function.
Conclusions:
EPC populations differ in regards to their associations with CAD severity. The number and function of OECs, but not early EPCs, correlated significantly with epicardial CAD severity. There was no relationship between EPCs and severity of coronary microvascular disease.
