Correlation of circulating endothelial progenitor cells and cerebral atherosclerotic burden in patients with large artery atherosclerotic stroke

Abstract

Objective To investigate the correlation of the level of circulating endothelial progenitor cells (EPCs) and cerebral atherosclerosis burden (CAB) in patients with large artery atherosclerotic stroke (LAAS) and its predictive effect for LAAS. Methods Consecutive patients with LAAS and healthy controls were enrolled. Flow cytometry wad used to detect EPC level in peripheral blood. CAB was assessed according to the results of CT angiography or magnetic resonance angiography. Univariate analysis was used to compare the demographic and clinical data in both groups. Multivariate logistic regression analysis was used to identify the correlation of circulating EPC level and LAAS. Results A total of 141 patients with LAAS and 100 controls were enrolled. The constituent ratios of hypertension (65.9% vs. 51.0%; χ2 =5.443, P=0.020) and diabetes (27.0% vs. 16.0%; χ2 =4.035, P=0.045) of the patents, as well as systolic blood pressure (139.1±11.1 mmHg vs. 131.6±15.7 mmHg; t=3.549, P=0.003; 1 mmHg=0.133 kPa) and fasting blood glucose (5.8±2.1 mmol/L vs. 5.2±2.0 mmol/L; t=2.344, P=0.020) in the patient group were significantly higher than those in the control group, while the circulating EPC level (median, interquartile range) (13[3-32] /ml vs. 31[7-59]/ml; Z=3.913, P=0.001) was significantly lower than the control group. Multivariate logistic regression analysis showed that the decreased circulating EPC level (odd ratio 2.632, 95% confidence interval 1.412-4.907, P=0.002) was an independent risk factor for LAAS after adjusting the confounders. The EPC level in the CAB >3 group was significantly lower than that in the CAB 1 group (5 [2-19]/ml vs. 22 [9-43]/ml; Z=3.338, P=0.011). Spearman rank correlation analysis showed that the EPC level was significantly negatively correlated with CAB (r=-0.257, P=0.002). Conclusions The decreased circulating EPC level was an indenpendent risk factor for the onset of LAAS, and the EPC level was negatively correlated with CAB. Key words: Endothelial Progenitor Cells; Stroke; Brain Ischemia; Atherosclerosis; Risk Factors