Circulating CD34+ progenitor cells and growth factors in patients treated with PCI for acute myocardial infarction or stable angina pectoris

Abstract

Objective. To differentiate the effect of myocardial infarction from the effect of percutaneous coronary intervention (PCI) on the circulatory profiles of CD34+ cells and growth factors in patients with ST-elevation myocardial infarction (STEMI). Methods. Twenty patients with STEMI and 10 with angina pectoris (AP) were included. All were treated with PCI. Blood was drawn before PCI in the AP group, and after 3 and 12 hours, and 1, 3, 5, 7 and 14 days after PCI in both groups. In STEMI patients, correlation analyses between TIMI myocardial perfusion grade (TMP-grade) and circulating CD34+cells were also assessed. Results. Circulating CD34+ cells increased from day 1 to days 5 and 7 after PCI only in STEMI patients (p < 0.05). Between-group analyses revealed a borderline significant difference in change in SDF-1α concentrations from 3 h to 14 days after PCI (p = 0.05), and SDF-1α was significantly higher in STEMI patients 14 days after PCI (p < 0.05). In both groups, peak HGF concentrations were observed 3 h after PCI, whereas IGF-1 increased in AP patients only, 3 h after PCI (p < 0.005). TIMI perfusion grade was negatively correlated to the circulating number of CD34+ cells 5 days after PCI (r =−0.69, p < 0.005). Conclusion. After PCI, STEMI patients have significantly higher numbers of circulating CD34+ progenitor cells compared to patients with AP. STEMI results in a significant increase in SDF-1α after 14 days, and the increase at this time may indicate a favorable environment for progenitor cell therapy.