Abstract 14207: Endothelial Progenitor Cells, T Cells and Macrophages’ Peripheral Levels as Possible Predictive Biomarkers of Acute Myocardial Infarction

Abstract

Introduction: Acute myocardial infarcted (AMI) patient prognosis is strictly dependent on early diagnosis and the adoption of adequate interventions. Hypothesis: Immune cells' blood level as a possible candidate to use distinct diagnostic biomarkers of AMI (H1) with/out the combination with clinical-laboratory findings are little known (H2). Materials &Methods: Eighteen patients with the diagnosis of AMI were enrolled. Patients with a history of chronic inflammatory disease excluded. All patients underwent emergent percutaneous coronary intervention via the radial artery and guided by optical coherence tomography. Peripheral blood was drawn after obtaining informed consent from patients at days three and seven (MI-D3 & MI-D7) after onset AMI along with sixteen healthy volunteers as a control. The mononuclear cells isolated by density gradient centrifugation and evaluated with EPCs colony formation assay, and flow cytometry analysis (FCA). Results: FCA revealed that total mononuclear live cells were significantly lower at MI-D3 and MI-D7 in myocardial infarcted patients compared with healthy controls (55.18±6.7 vs. 77.5±2, P>0.01; and 64.52±7.33 vs. 77.5±2, P>0.08, respectively). An area under the ROC curve (AUC) in MI-D3 was 0.95 (P>0.0007), that is, total CD34+cells/ml counts for MI-D3 vs. healthy controls whereas at MI-D7 the value of EPCs as a predictor was reduced AUC=0.71(P<0.16). In correlation analysis, coronary vessels lesions number inversely correlates vs. MI-D3 total EPCs number (r= -0.45) but not at MI-D7 (r= 0.39). Correlation test showed the tendency of a positive correlation between creatine kinase myocardial band to CD8+ cells at MI-D3 (r=0.58; P<0.054) but not at MI-D7. ROC curve analysis depicted a high accuracy AMI prediction rate of CD8+ cells at MI-D3 (AUC=0.94; P>0.0004) and MI-D7 (AUC=0.85; P>0.03). Notably, all T cells subsets negatively correlated with myeloid cell subsets such as M1 and M2 macrophages at MI-D7, indicating T cells loss in PB stream compensated by monocyte/macrophage. Conclusion: Our data demonstrated that circulating EPCs number associates with cardiac vessel lesion, whereas CD8+ cells may serve as a high accuracy biomarker of AMI with a combination of classical clinical-laboratory findings.