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Published on: September 22, 2020
Endothelial progenitor cells have high predictive value for ventricular remodeling after percutaneous coronary
Yongxiang Ma1, Lijian Niu, Jing Zhang
1Department of Cardiology, The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou City, Jiangsu Province, China.
Insights
Low endothelial progenitor cell (EPC) levels predict adverse ventricular remodeling after acute myocardial infarction (AMI) and percutaneous coronary intervention (PCI). Monitoring EPCs can identify patients at higher risk for poor outcomes.
Area of Science:
- Cardiology
- Regenerative Medicine
- Biomarker Research
Background:
- Acute myocardial infarction (AMI) and subsequent heart failure are leading global causes of mortality and disability.
- Endothelial progenitor cells (EPCs) play a crucial role in vascular repair and have been linked to AMI outcomes.
Purpose of the Study:
- To evaluate the predictive capability of EPC levels for post-percutaneous coronary intervention (PCI) ventricular remodeling in patients who have experienced AMI.
- To assess the association between EPC levels and the risk of developing ventricular remodeling after PCI in AMI patients.
Main Methods:
- Retrospective analysis of 215 AMI patients undergoing PCI, categorized into ventricular remodeling (VR) and non-ventricular remodeling (N-VR) groups.
- Measurement of left ventricular ejection fraction (LVEF), N-terminal pro-brain natriuretic peptide (NT-pro-BNP), and EPC levels.
- Statistical analyses including Spearman's correlation, receiver-operating characteristic (ROC) curves, and Kaplan-Meier survival analysis.
Main Results:
- Patients with post-PCI ventricular remodeling (VR group) exhibited lower LVEF and EPC levels, and higher NT-pro-BNP levels compared to the N-VR group.
- EPC levels positively correlated with LVEF (r=0.683) and negatively with NT-pro-BNP (r=-0.761).
- EPCs demonstrated significant predictive value for post-PCI ventricular remodeling in AMI patients (AUC=0.822) and particularly in anterior MI patients (AUC=0.941). Low EPC levels were associated with increased remodeling risk.
Conclusions:
- Diminished EPC levels serve as a strong predictor of post-PCI ventricular remodeling in AMI patients.
- Low EPC counts significantly elevate the risk of developing ventricular remodeling following PCI in the context of AMI.
Objective:
Acute myocardial infarction (AMI) and the following heart failure are main causes of disability and death across the globe. Endothelial progenitor cell (EPC) levels are linked to AMI. Herein, we assessed the predictive value of EPCs for post-percutaneous coronary intervention (PCI) ventricular remodeling in AMI patients.
Methods:
This study retrospectively analyzed 215 AMI patients receiving PCI, who were then categorized into the VR ( n = 66) and N-VR ( n = 149) groups as per whether they developed post-PCI ventricular remodeling. Left ventricular ejection fraction (LVEF), N-terminal pro-brain natriuretic peptide (NT-pro-BNP), and EPCs were measured. The correlations of LVEF and NT-pro-BNP with EPCs, the predictive value of EPCs for post-PCI ventricular remodeling, and the risk of post-PCI ventricular remodeling in AMI patients with different EPC levels were analyzed by Spearman's analysis, receiver-operating characteristic curve, and Kaplan-Meier curve.
Results:
LVEF and EPC levels were lower and NT-pro-BNP level was higher in the VR group than the N-VR group. EPC levels in the class III-IV group were lower than those in the class I-II group. EPC levels in AMI patients correlated positively with LVEF ( r = 0.683) and negatively with NT-pro-BNP ( r = -0.761). EPCs exhibited high predictive value for post-PCI ventricular remodeling in AMI [area under the curve (AUC) of 0.822] and anterior MI (AUC = 0.941) patients. AMI and anterior MI patients with low EPC levels had a higher risk of post-PCI ventricular remodeling.
Conclusion:
Low EPC levels have high predictive value for post-PCI ventricular remodeling, and increase the risk of post-PCI ventricular remodeling in AMI patients.
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