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Endothelial progenitor cells predict long-term prognosis in patients with stable angina treated with percutaneous coronary intervention: five-year follow-up of the PROCREATION study.
Pelliccia, Francesco; Pasceri, Vincenzo; Rosano, Giuseppe; Pristipino, Christian; Roncella, Adriana; Speciale, Giulio; Pannarale, Giuseppe; Schiariti, Michele; Greco, Cesare; Gaudio, Carlo.
Afiliación
  • Pelliccia F; Department of Cardiology, Sapienza University, Rome, Italy. f.pelliccia@mclink.it
Circ J ; 77(7): 1728-35, 2013.
Article en En | MEDLINE | ID: mdl-23575363
BACKGROUND: The association between endothelial progenitor cells (EPCs) at the time of percutaneous coronary intervention (PCI) and the subsequent long-term clinical outcome remains undefined. To address this issue, a pre-specified analysis of the PROgenitor Cells role in Restenosis and progression of coronary ATherosclerosis after percutaneous coronary intervention (PROCREATION) study was done. METHODS AND RESULTS: A total of 155 patients with stable angina treated with PCI had flow cytometry before PCI. Patients had a 5-year follow-up. Primary outcome was the composite of major adverse cardiac or cerebrovascular events (MACCE), that is, death, stroke, myocardial infarction, and revascularization. During follow-up, MACCE occurred in 65 of 155 patients (42%). There were no significant differences in clinical and angiographic variables between patients with or without MACCE, apart from a different extent of coronary atherosclerosis. The incidence of MACCE increased significantly over tertiles of CD34+/KDR+/CD45- cells and CD133+/KDR+/CD45- cells, with rates of 25%, 39%, and 69% (P=0.0001), and 26%, 44%, and 59% (P=0.003), respectively. On multivariate analysis it was estimated that the increase in CD34+/KDR+/CD45- cells was associated with a 35% higher risk for MACCE (hazard ratio [HR], 1.75; 95% confidence interval [CI]: 1.07-1.99; P=0.001), and the increase in CD133+/KDR+/CD45- cells was associated with a 25% higher risk for MACCE (HR, 1.35; 95% CI: 1.01-1.74; P=0.03). CONCLUSIONS: Assessment of subpopulations of circulating EPCs in patients with stable angina treated with PCI can improve characterization of long-term prognosis (ClinicalTrials.gov: NCT01575431).
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Células Madre / Antígenos de Diferenciación / Células Endoteliales / Angina Estable / Intervención Coronaria Percutánea Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Circ J Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2013 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Japón
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Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Células Madre / Antígenos de Diferenciación / Células Endoteliales / Angina Estable / Intervención Coronaria Percutánea Tipo de estudio: Clinical_trials / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Circ J Asunto de la revista: ANGIOLOGIA / CARDIOLOGIA Año: 2013 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Japón