Level and value of circulating endothelial progenitor cells in patients with acute myocardial infarction undergoing primary coronary angioplasty

Abstracts / Cardiovascular Revascularization Medicine 10 (2009) 259–276 Results: For the pre-PCI prediction of CI-AKI, CrCl significantly outperformed eGFR (Pb.014), while eGFR and CrCl significantly outperformed SCr (ROC: 0.64; 95% CI: 0.61–0.67, Pb.001). For predicting post-PCI dialysis, CrCl, eGFR, and SCr did not significantly differ. Both CrCl and eGFR outperformed SCr for predicting in-hospital mortality (Pb.01). Conclusion: Pre-PCI measurement of CrCl appears to be a better predictor of CI-AKI than eGFR or SCr. CrCl should be considered over SCr for predicting adverse events post-PCI, although further study is needed to confirm this result. doi:10.1016/j.carrev.2009.04.102

Level and value of circulating endothelial progenitor cells in patients with acute myocardial infarction undergoing primary coronary angioplasty Ali Youssef Moustafa a, Hsueh-Wen Chang b, Hon-Kan Yip c a Suez Canal University Hospital, Ismailia, Egypt b Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan c Division of Cardiology, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan Introduction: Circulating endothelial progenitor cells (EPCs) may rapidly increase following acute myocardial infarction (AMI). This study investigated the levels and values of circulating EPCs in acute STsegment elevation (ST-se) AMI patients undergoing primary coronary intervention (PCI). Methods: Blood samples for EPCs from 161 consecutive patients with ST-se AMI undergoing primary PCI were collected 24 h after primary PCI. Levels of circulating EPCs [staining markers: CD31/ CD34 (E1), CD62E/CD34 (E2), and KDR/CD34 (E3)] were examined by flow cytometry. Results: Level of circulating EPCs (E1–E3) was notably lower in AMI patients than in normal subjects (n=30) (all Pb.005). Additionally, patients with high EPCs (E1–E3) (N1.2%) had significantly lower left ventricular ejection fraction (LVEF) (b50 %), elevated white blood cell count and creatinine level, higher Killip score (defined as ≥Class 3), more advanced congestive heart failure (CHF) (defined as ≥Class 3), and increased 30-day mortality than those with low EPC (E1–E3) level (b1.2%) (all Pb.0001). Furthermore, both high Killip score and advanced CHF were independent predictors of increased EPC levels (all Pb.05). Moreover, multivariate analysis demonstrated that high EPC (E3) level was the single most important predictor of increased 30-day major adverse clinical outcome (MACO) (defined as high Killip score, advanced CHF, and 30-day mortality) (Pb.0001). Conclusions: Level of circulating EPCs is a major independent predictor of 30-day MACO in patients with ST-se AMI undergoing primary PCI. doi:10.1016/j.carrev.2009.04.103

Genetic background of endothelium dysfunction in Uzbek hypertensive patients Marietta Eliseyeva, Gulnoz Khamidullaeva Centre of Cardiology, Tashkent, Uzbekistan Background: The new focus of attention in preventing and treating cardiovascular disease today is shifting toward the arterial wall. Evidence has been accumulating that protecting the endothelium is the key for reducing cardiovascular risk. Relationship between candidate gene polymorphism (PM) and endothelium dysfunction (ED) has been described in essential hypertension (EH). We study the association between the following gene PMs (I/D of ACE, A1166C of AT1R, M235T of AGT, 4a/4b of eNOS ,

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+9/−9 of B2R, Gln27Glu of β2-AR, C825T of GNB3, G460T of ADD) and markers of ED. Methods: We examined 174 Uzbek men with EH and 60 healthy persons. Endothelial function was evaluated by measuring the flow-mediated dilatation (FMD) of the brachial artery. Common carotid intimae-media thickness (IMT) was measured by high-resolution ultrasound. Microalbuminuria was defined as an albumin urinary excretion (AUE) between 20 and 200 mg/l. Genomic DNA was extracted from peripheral blood using Diatom DNA Prep 200 Kit according to the manufacturer's protocol. Examined PMs were determined using PCR. Results: Frequencies of genotype and allele of all PMs did not differ significantly between hypertensive and normotensive subjects. Genotype distribution did not deviate from Hardy–Weinberg equilibrium. Statistically significant association between polymorphic markers and markers of ED was found for PM of ACE, B2R, eNOS, AGT, AT1R genes. D/Dhomozygous of ACE had higher IMT than I/I-homozygous: 1.0±0.1 vs. 0.9±0.1 mm (Pb.05). Patients with 4a/4b+4a/4a genotypes of eNOS had higher IMT, AUE, and lower FMD than 4b/4b homozygous (1.05±0.16 vs. 0.94±0.14 mm, Pb.05; 34.5±10 vs. 28.3±12.2 mg/L, Pb.05; 0.6±7.1% vs. 4.2±5.8%, P=.02). Patients with 1166C allele of AT1R had lower FMD than patients with 1166A allele (0.9±9.9% vs. 3.9±7.8%, P=.03). Patients with 235T allele of AGT had lower FMD than patients with 235M allele (1.8±6.5% vs. 7.6±6.3%, P=.02). +9/+9 homozygous of B2R had paradox vasoconstriction in 50% vs. 16.7% in −9/−9 homozygous (P=.03) and higher IMT: 1.16±0.18 vs. 0.95±0.16 mm (P=.000). Conclusions: Results of research testify to the association of PMs of ACE, AT1R, AGT, eNOS, and B2R genes with ED and vascular remodeling in EH. doi:10.1016/j.carrev.2009.04.104

First 5 years' follow-up of first group of South American patients with repaired myocardial infarction by autologous intracoronary bone marrow stem cells implant Roberto J. Fernandez Vina a, Jorge Saslavsky b, Francisco Vrsalovic c, Oberdan Andrin c, Federico Fernandez Vina d, Liliana Camozzi e, Janaina Ferreira da Silva Lima e a Maimonides University Argentina and Fernandez Vina Foundation, San Nicolas, Argentina b Rosario University Argentina and Fernandez Vina Foundation, Rosario, Argentina c Fernandez Vina Foundation and San Nicolas Private Hospital, San Nicolas, Argentina d Fernandez Vina Foundation and San Nicolas Clinic and Hospital, San Nicolas, Argentina e Fernandez Vina Foundation, San Nicolas, Argentina Objectives: To report the long time performance of the left ventricular function recovered after AMI treated with stems cells implant (TeCelCor-1Argentina). Methods: A total of 37 patients who suffered AMI in 2003 were treated with primary PTCA with stents. The ventriculography ejection fraction was oscillated between 20% and 32%. Between 7 and 12 days after AMI cells were implanted via the coronary artery with occlusion of the coronary sinus, autologous mononuclear cells CD 34(+) and CD38 (−) (mean number of cells 20×10 6) were injected. This group, named the stem cells group (SCG), was compared with a control group (CG) of 36 patients who suffered an MI of similar characteristics; these patients only received PTCA and a stent. Results: After 360 days, we performed a coronariography and a ventriculography. In the SCG, all the stents were permeable vs. 29% restenosis in the CG. In the SCG, EF improved by an average of 72% in relationship to the basal EF vs. 33% in the CG. The patients were followed up for up to 5 years. During 5 years, EF was controlled using serial echocardiograms. Minimal deterioration of the contractile function was