Endothelial Progenitor Cells in Coronary Artery Disease: From Bench to Bedside
Francesco Pelliccia1, Marco Zimarino2,3, Giuseppe De Luca4
1Department of Cardiovascular Sciences, Sapienza University, Rome, Italy.
Insights
Endothelial progenitor cells (EPCs) are key in coronary artery disease (CAD). Their levels may predict long-term outcomes in CAD patients, offering new biomarker potential.
Area of Science:
- Cardiovascular Research
- Cell Biology
- Biomarker Discovery
Background:
- Endothelial progenitor cells (EPCs) are circulating cells involved in endothelial repair.
- Their role in coronary artery disease (CAD) progression and post-intervention outcomes remains debated.
- Understanding EPCs' clinical significance is crucial for managing CAD patients.
Purpose of the Study:
- To review the current understanding of EPCs in CAD.
- To summarize EPC associations with cardiovascular risk factors, atherosclerosis, and ischemia.
- To discuss EPCs' role in neointimal growth and potential as predictive biomarkers.
Main Methods:
- Literature review of experimental and clinical studies on EPCs in CAD.
- Synthesis of findings on EPCs' association with cardiovascular risk factors.
- Analysis of EPCs' role in atherosclerosis and post-percutaneous coronary intervention (PCI) outcomes.
Main Results:
- EPC levels show controversial associations with atherosclerosis and neointimal growth.
- EPCs are linked to cardiovascular risk factors, coronary atherosclerosis, and myocardial ischemia.
- Evidence suggests EPCs may predict long-term outcomes in CAD patients.
Conclusions:
- EPCs are emerging as potential predictive biomarkers for long-term outcomes in CAD.
- Further research is needed to clarify the precise role and clinical utility of EPCs.
- EPCs may offer novel therapeutic targets or diagnostic tools in cardiovascular medicine.
Abstract:
Endothelial progenitor cells (EPCs) are a heterogeneous group of cells present in peripheral blood at various stages of endothelial differentiation. EPCs have been extensively investigated in patients with coronary artery disease (CAD), with controversial findings both on their role in atherosclerosis progression and in the process of neointimal growth after a percutaneous coronary intervention (PCI). Despite nearly 2 decades of experimental and clinical investigations, however, the significance of EPCs in clinical practice remains unclear and poorly understood. This review provides an update on the role of EPCs in the most common clinical scenarios that are experienced by cardiologists managing patients with CAD. We here summarize the main findings on the association of EPCs with cardiovascular risk factors, coronary atherosclerosis, and myocardial ischemia. We then discuss the potential effects of EPCs in post-PCI in-stent restenosis, as well as most recent findings with EPC-coated stents. Based on the mounting evidence of the relationship between levels of EPCs and several different adverse cardiovascular events, EPCs are emerging as novel predictive biomarkers of long-term outcomes in patients with CAD.
