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Updated: Apr 20, 2026
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Plasma stromal cell-derived factor 1α/CXCL12 level predicts long-term adverse cardiovascular outcomes in patients
Nima Ghasemzadeh1, Abdul Wahab Hritani1, Christine De Staercke2
1Emory University School of Medicine, Atlanta, GA, USA.
Insights
High levels of stromal derived factor-1α (CXCL12) predict poor cardiovascular outcomes in coronary artery disease (CAD) patients. This biomarker improves risk assessment for cardiovascular death and myocardial infarction.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Cellular Signaling
Background:
- Stromal derived factor-1α (CXCL12) is a chemoattractant crucial for progenitor cell homing to ischemic tissues.
- Its role in long-term cardiovascular outcomes in coronary artery disease (CAD) requires further investigation.
Purpose of the Study:
- To investigate the association between plasma CXCL12 levels and long-term cardiovascular outcomes in patients with CAD.
- To determine if CXCL12 improves cardiovascular risk prediction models.
Main Methods:
- 785 patients undergoing coronary angiography were enrolled in discovery and replication cohorts.
- Plasma CXCL12 levels were measured using ELISA.
- Patients were followed for cardiovascular death and/or myocardial infarction (MI) for a mean of 2.6 years.
- Cox proportional hazard models were used to identify predictors of cardiovascular events.
Main Results:
- High plasma CXCL12 levels independently predicted cardiovascular death/MI (HR=4.81, p=1×10⁻⁶).
- In pooled analysis, CXCL12 improved risk prediction model discrimination (AUC: 0.67-0.73, p=0.03).
- CXCL12 addition led to significant risk reclassification for events and non-events, findings replicated in independent cohorts.
Conclusions:
- Plasma CXCL12 is a potent, independent predictor of adverse cardiovascular outcomes in CAD patients.
- Measuring plasma CXCL12 enhances cardiovascular risk stratification and reclassification.
Objective:
Stromal derived factor-1α/CXCL12 is a chemoattractant responsible for homing of progenitor cells to ischemic tissues. We aimed to investigate the association of plasma CXCL12 with long-term cardiovascular outcomes in patients with coronary artery disease (CAD).
Methods:
785 patients aged: 63 ± 12 undergoing coronary angiography were independently enrolled into discovery (N = 186) and replication (N = 599) cohorts. Baseline levels of plasma CXCL12 were measured using Quantikine CXCL12 ELISA assay (R&D systems). Patients were followed for cardiovascular death and/or myocardial infarction (MI) for a mean of 2.6 yrs. Cox proportional hazard was used to determine independent predictors of cardiovascular death/MI.
Results:
The incidence of cardiovascular death/MI was 13% (N = 99). High CXCL12 level based on best discriminatory threshold derived from the ROC analysis predicted risk of cardiovascular death/MI (HR = 4.81, p = 1 × 10(-6)) independent of traditional risk factors in the pooled cohort. Addition of CXCL12 to a baseline model was associated with a significant improvement in c-statistic (AUC: 0.67-0.73, p = 0.03). Addition of CXCL12 was associated with correct risk reclassification of 40% of events and 10.5% of non-events. Similarly for the outcome of cardiovascular death, the addition of the CXCL12 to the baseline model was associated with correct reclassification of 20.7% of events and 9% of non-events. These results were replicated in two independent cohorts.
Conclusion:
Plasma CXCL12 level is a strong independent predictor of adverse cardiovascular outcomes in patients with CAD and improves risk reclassification.
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