Abstract
IntroductionThe aim of this study was to determine prognostic factors for the risk of new vascular events during the first 6 months after acute myocardial infarction (AMI) or atherothrombotic stroke (AS). We were interested in the prognostic role of endothelial progenitor cells (EPC) and circulating endothelial cells (CEC)MethodsBetween February 2009 and July 2012, 100 AMI and 50 AS patients were consecutively studied in three Spanish centres. Patients with previously documented coronary artery disease or ischemic strokes were excluded. Samples were collected within 24h of onset of symptoms. EPC and CEC were studied using flow cytometry and categorized by quartiles. Patients were followed for up to 6 months. NVE was defined as new acute coronary syndrome, transient ischemic attack (TIA), stroke, or any hospitalization or death from cardiovascular causes. The variables included in the analysis included: vascular risk factors, carotid intima-media thickness (IMT), atherosclerotic burden and basal EPC and CEC count. Multivariate survival analysis was performed using Cox regression analysis.ResultsDuring follow-up, 19 patients (12.66%) had a new vascular event (5 strokes; 3 TIAs; 4 AMI; 6 hospitalizations; 1 death). Vascular events were associated with age (P = 0.039), carotid IMT≥0.9 (P = 0.044), and EPC count (P = 0.041) in the univariate analysis. Multivariate Cox regression analysis showed an independent association with EPC in the lowest quartile (HR: 10.33, 95%CI (1.22–87.34), P = 0.032] and IMT≥0.9 [HR: 4.12, 95%CI (1.21–13.95), P = 0.023].ConclusionsBasal EPC and IMT≥0.9 can predict future vascular events in patients with AMI and AS, but CEC count does not affect cardiovascular risk.
Highlights
The aim of this study was to determine prognostic factors for the risk of new vascular events during the first 6 months after acute myocardial infarction (AMI) or atherothrombotic stroke (AS)
Vascular events were associated with age (P = 0.039), carotid IMT0.9 (P = 0.044), and endothelial progenitor cells (EPC) count (P = 0.041) in the univariate analysis
Multivariate Cox regression analysis showed an independent association with EPC in the lowest quartile (HR: 10.33, 95%confidence intervals (CI) (1.22–87.34), P = 0.032] and IMT0.9 [hazard ratio (HR): 4.12, 95%CI (1.21–13.95), P = 0.023]
Summary
The aim of this study was to determine prognostic factors for the risk of new vascular events during the first 6 months after acute myocardial infarction (AMI) or atherothrombotic stroke (AS). The aim of the study was to compare the short- and long-term mobilization of EPCs and CECs following an AMI or an atherothrombotic stroke (AS), as this type of stroke shares the same etiology, large-vessel disease, and high cardiovascular risk of CAD [15,16]. We aimed to determine the effect of basal EPC and CEC on the risk of new vascular events (NVE) among high-risk vascular patients. Apart from the cell analysis, we aimed to identify other clinical variables with a predictive role in vascular risk
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