TITLE

Circulating Progenitor Cell Count for Cardiovascular Risk Stratification: A Pooled Analysis

AUTHOR(S)

Fadini, Gian Paolo; Maruyama, Shoichi; Ozaki, Takenori; Taguchi, Akihiko; Meigs, James; Dimmeler, Stefanie; Zeiher, Andreas M.; Kreutzenberg, Saula de; Avogaro, Angelo; Nickenig, Georg; Schmidt-Lucke, Caroline; Werner, Nikos

PUB. DATE

July 2010

SOURCE

PLoS ONE;2010, Vol. 5 Issue 7, p1

SOURCE TYPE

Academic Journal

DOC. TYPE

Article

ABSTRACT

Background: Circulating progenitor cells (CPC) contribute to the homeostasis of the vessel wall, and a reduced CPC count predicts cardiovascular morbidity and mortality. We tested the hypothesis that CPC count improves cardiovascular risk stratification and that this is modulated by low-grade inflammation. Methodology/Principal Findings: We pooled data from 4 longitudinal studies, including a total of 1,057 patients having CPC determined and major adverse cardiovascular events (MACE) collected. We recorded cardiovascular risk factors and high-sensitive C-reactive protein (hsCRP) level. Risk estimates were derived from Cox proportional hazard analyses. CPC count and/or hsCRP level were added to a reference model including age, sex, cardiovascular risk factors, prevalent CVD, chronic renal failure (CRF) and medications. The sample was composed of high-risk individuals, as 76.3% had prevalent CVD and 31.6% had CRF. There were 331 (31.3%) incident MACE during an average 1.7±1.1 year follow-up time. CPC count was independently associated with incident MACE even after correction for hsCRP. According to C-statistics, models including CPC yielded a non-significant improvement in accuracy of MACE prediction. However, the integrated discrimination improvement index (IDI) showed better performance of models including CPC compared to the reference model and models including hsCRP in identifying MACE. CPC count also yielded significant net reclassification improvements (NRI) for CV death, non-fatal AMI and other CV events. The effect of CPC was independent of hsCRP, but there was a significant more-than-additive interaction between low CPC count and raised hsCRP level in predicting incident MACE. Conclusions/Significance: In high risk individuals, a reduced CPC count helps identifying more patients at higher risk of MACE over the short term, especially in combination with a raised hsCRP level.

ACCESSION #

52884366

Tags: CYTOLOGY -- Research;  CARDIOVASCULAR system -- Diseases -- Risk factors;  LONGITUDINAL method;  C-reactive protein;  HOMEOSTASIS;  PROPORTIONAL hazards models;  COHORT analysis;  INFLAMMATION;  CHRONIC renal failure;  PATIENTS -- Medical care

 

Related Articles

• Serum parathyroid hormone and risk of adverse outcomes in patients with stable coronary heart disease. Grandi, Norma Christine; Breitling, Lutz Philipp; Hahmann, Harry; W�sten, Bernd; Mi�rz, Winfred; Rothenbacher, Dietrich; Brenner, Hermann // Heart;Aug2011, Vol. 97 Issue 15, p1215 

  Background and objective Recent longitudinal studies have suggested an association of high serum parathyroid hormone levels (PTH) with elevated cardiovascular risk in the general population. This study presents analyses of the prognostic value of baseline PTH for subsequent cardiovascular events...

• CD4+CD28null cells are expanded and exhibit a cytolytic profile in end-stage renal disease patients on peritoneal dialysis. Yadav, Ashok Kumar; Jha, Vivekanand // Nephrology Dialysis Transplantation;May2011, Vol. 26 Issue 5, p1689 

  Background. End-stage renal failure patients, including those on peritoneal dialysis (PD), exhibit several nontraditional cardiovascular (CV) risk factors. A role of CD4+CD28null T lymphocytes in the genesis of coronary artery disease (CAD) has been proposed. We investigated this cell population...

• Factors Associated with Arterial Vascular Events in PROFILE: A Multiethnic Lupus Cohort. Bertoli, A. M.; Vil�, L. M.; Alarc�n, G. S.; McGwin Jr., G.; Edberg, J. C.; Petri, M.; Ramsey-Goldman, R.; Reveille, J. D.; Kimberly, R. P. // Lupus;Oct2009, Vol. 18 Issue 11, p958 

  The objective of this study was to determine the factors associated with the occurrence of arterial vascular events in a multiethnic systemic lupus erythematosus (SLE) cohort. The PROFILE cohort, comprised SLE patients (n = 1333) of defined ethnicity from five different US institutions, was...

• Oral Health Behavior and Metabolic Syndrome and Its Components in Adults. Kobayashi, Y.; Niu, K.; Guan, L.; Momma, H.; Guo, H.; Cui, Y.; Nagatomi, R. // Journal of Dental Research;May2012, Vol. 91 Issue 5, p479 

  Inflammation has been strongly related to metabolic syndrome (MetS). Periodontal disease is the most common chronic infection in adults. We investigated a cross-sectional (n = 925) and 3-year longitudinal (n = 685) relationship between the daily frequency of toothbrushing and MetS. In the...

• Annual variation in body fat is associated with systemic inflammation in chronic kidney disease patients Stages 3 and 4: a longitudinal study. Carvalho, Laura Kawakami; Barreto Silva, Maria Ines; da Silva Vale, Barbara; Bregman, Rachel; Martucci, Renata Brum; Carrero, Juan Jesus; Avesani, Carla Maria // Nephrology Dialysis Transplantation;Apr2012, Vol. 27 Issue 4, p1423 

  Background. In dialysis patients, cross-sectional studies show that total and abdominal body fat associate with inflammatory markers. Whether this is true in earlier disease stages is unknown. We evaluated the cross-sectional and longitudinal (12-month interval) association between body fat...

• Sleep-Time Blood Pressure as a Therapeutic Target for Cardiovascular Risk Reduction in Type 2 Diabetes. Hermida, Ramón C.; Ayala, Diana E.; Mojón, Artemio; Fernández, José R. // American Journal of Hypertension;Mar2012, Vol. 25 Issue 3, p325 

  BackgroundIndependent studies have found that elevated sleep-time blood pressure (BP) is a better predictor of cardiovascular risk than the awake or 24-h BP means in patients without as well as with diabetes. However, the impact of the alteration over time of ambulatory BP on cardiovascular risk...

• Oxidative stress in children on hemodialysis: value of autoantibodies against oxidized low-density lipoprotein. Cengiz, Nurcan; Baskin, Esra; Sezgin, Nurzen; Agras, Pinar; Haberal, Mehmet // Pediatric Nephrology;Feb2009, Vol. 24 Issue 2, p387 

  The principal causes of morbidity and mortality in children with chronic renal failure on maintenance hemodialysis are cardiovascular complications. Recently, it has been suggested that oxidative stress, chronic inflammation and malnutrition are risk factors for cardiovascular disease. However,...

• Restless legs syndrome enhances cardiovascular risk and mortality in patients with end-stage kidney disease undergoing long-term haemodialysis treatment. La Manna, Gaetano; Pizza, Fabio; Persici, Elisa; Baraldi, Olga; Comai, Giorgia; Cappuccilli, Maria Laura; Centofanti, Francesca; Carretta, Elisa; Plazzi, Giuseppe; Col�, Luigi; Montagna, Pasquale; Stefoni, Sergio // Nephrology Dialysis Transplantation;Jun2011, Vol. 26 Issue 6, p1976 

  Background. Restless legs syndrome (RLS) is a sensorimotor neurological disorder characterized by paraesthesia, dysaesthesia and the irresistible urge to move the legs especially at night. Its prevalence is much higher among dialysis patients at 12 to 62% compared to 3 to 9% in the general...

• Clearance of middle molecules during haemodialysis and haemodiafiltration: new insights. Leypoldt, John K.; Holmes, Clifford J.; Rutherford, Peter // Nephrology Dialysis Transplantation;Dec2012, Vol. 27 Issue 12, p4245 

  No abstract available.

Read the Article