Endothelial Progenitor Cells Predict Cardiovascular Events after Atherothrombotic Stroke and Acute Myocardial...

Area of Science:

• Cardiovascular Medicine
• Vascular Biology
• Biomarkers

Background:

• Acute myocardial infarction (AMI) and atherothrombotic stroke (AS) pose significant risks for subsequent vascular events.
• Identifying reliable prognostic factors is crucial for early intervention and risk stratification.
• Endothelial progenitor cells (EPC) and circulating endothelial cells (CEC) are potential biomarkers of vascular health.

Purpose of the Study:

• To determine prognostic factors for new vascular events within 6 months post-AMI or AS.
• To investigate the predictive role of EPC and CEC in patients experiencing acute cardiovascular events.

Main Methods:

• Prospective study of 150 patients (100 AMI, 50 AS) excluding those with prior coronary artery disease or ischemic strokes.
• Flow cytometry analysis of EPC and CEC counts at baseline.
• Follow-up for 6 months to assess new vascular events (NVE), defined by recurrent events or cardiovascular hospitalizations/death.
• Multivariate Cox regression analysis incorporating vascular risk factors, carotid intima-media thickness (IMT), and cell counts.

Main Results:

• 19 patients (12.66%) experienced a new vascular event during follow-up.
• Univariate analysis identified age, IMT ≥ 0.9 mm, and EPC count as associated with NVE.
• Multivariate analysis revealed independent associations between the lowest quartile of EPC (HR: 10.33) and IMT ≥ 0.9 mm (HR: 4.12) with increased risk of future vascular events.

Conclusions:

• Basal EPC levels and elevated carotid IMT (≥ 0.9 mm) are significant predictors of future vascular events in patients with AMI and AS.
• CEC count did not demonstrate a significant association with cardiovascular risk in this cohort.
• These findings highlight the prognostic utility of EPC and IMT in risk stratification for secondary vascular events.