Platelet surface expression of SDF-1 is associated with clinical outcomes in the patients with cardiovascular disease
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Updated: Mar 17, 2026
Flow Cytometry Analysis of Tissue Factor Expression in Human Platelets
Published on: November 22, 2024
Dominik Rath1, Madhumita Chatterjee1, Angela Bongartz1
1a Medizinische Klinik III, Kardiologie und Kreislauferkrankungen , University Tübingen , Tübingen , Germany.
Insights
High platelet stromal cell derived factor 1 (SDF-1) levels are linked to worse outcomes in coronary artery disease (CAD) patients. This finding suggests SDF-1 may be a novel biomarker for predicting adverse events in CAD.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Biomarkers
Background:
- Platelet stromal cell derived factor 1 (SDF-1) is implicated in cardiovascular conditions like acute coronary syndrome and myocardial infarction.
- Elevated SDF-1 expression in platelets and myocardium suggests a role in inflammatory cardiomyopathy and fibrosis.
- The prognostic impact of platelet SDF-1 on outcomes in symptomatic coronary artery disease (CAD) patients remains largely unknown.
Purpose of the Study:
- To investigate the association between baseline platelet SDF-1 expression levels and clinical outcomes in patients with symptomatic CAD.
- To determine if elevated platelet SDF-1 is an independent predictor of major adverse cardiovascular events.
Main Methods:
- Blood samples from 608 consecutive CAD patients were collected during percutaneous coronary intervention.
- Platelet surface SDF-1 expression was quantified using flow cytometry.
- Primary endpoint: composite of myocardial infarction (MI), ischemic stroke, or all-cause death. Secondary endpoints: individual components of the primary endpoint.
Main Results:
- Patients with platelet SDF-1 levels in the highest quartile (>Q3) exhibited significantly worse event-free survival compared to those with lower levels (P=0.009 for primary endpoint).
- Higher SDF-1 levels were also associated with a significantly worse survival for the secondary endpoint of all-cause death (P=0.016).
- Multivariate Cox regression analysis confirmed that SDF-1 levels >Q3 were independently associated with an increased risk of the primary combined endpoint and all-cause death.
Conclusions:
- This study provides the first clinical evidence that elevated platelet SDF-1 expression negatively impacts clinical outcomes in CAD patients.
- High platelet SDF-1 levels may serve as an independent prognostic biomarker for adverse events in symptomatic coronary artery disease.
- Further research could explore therapeutic strategies targeting SDF-1 to improve outcomes in CAD.
Abstract:
Platelet surface expression levels of stromal cell derived factor 1 (SDF-1) are elevated in acute coronary syndrome and associated with LVEF% improvement after myocardial infarction (MI). Platelet SDF-1 might facilitate thrombus formation and endomyocardial expression of SDF-1 is enhanced in inflammatory cardiomyopathy and positively correlates with myocardial fibrosis. The influence of platelet SDF-1 on outcome in the patients with symptomatic coronary artery disease (CAD) is to the best of our knowledge unknown. Blood samples of 608 consecutive CAD patients were collected during the percutaneous coronary intervention and analyzed for surface expression of SDF-1 by flow cytometry. The primary combined endpoint was defined as the composite of either MI, or ischemic stroke, or all-cause death. Secondary endpoints were defined as the aforementioned single events. The patients with baseline platelet SDF-1 levels above the third quartile showed a significantly worse cumulative event-free survival when compared to the patients with lower baseline SDF-1 levels (first to third quartile) (log rank 0.009 for primary combined endpoint and log rank 0.016 for secondary endpoint all-cause death). Multivariate Cox regression analysis showed that SDF-1 levels above the third quartile were independently associated with the primary combined endpoint and the secondary endpoint all-cause death. We provide first clinical evidence that high platelet expression levels of SDF-1 influence clinical outcomes in CAD patients in a negative way.
