Coronary artery diseasePeripheral CD34+ Cells and the Risk of In-Stent Restenosis in Patients With Coronary Heart Disease
Section snippets
Patients, angioplasty, and stenting procedure
Men treated at the University Hospital Aachen were enrolled in a single-center prospective study. The inclusion criteria were successful elective stenting of a single de novo coronary lesion (>50% diameter stenosis) in men aged 18 to 85 years, who had been diagnosed with stable or unstable angina or silent ischemia. The exclusion criteria were an ejection fraction of <30%, unprotected left main location, heavy calcification, excessive tortuosity of the proximal vessel, use of a drug-eluting
Patient characteristics
The study population consisted of 17 men with successful elective coronary stenting, follow-up angiographic data, and none of the exclusion criteria applicable. The mean age was 66.8 years, with a high prevalence of dyslipidemia, diabetes, and hypertension (Table 1). The target vessel was the left anterior descending artery in 41.2% of the patients, right coronary artery in 11.6%, and left circumflex artery in 41.2%. Although all target lesions were primary lesions, 17.6% of the patients had
Discussion
Although a role for bone marrow–derived, circulating SMC progenitors in neointima formation after vascular injury has been demonstrated in animal models, a relation between circulating progenitor cells and in-stent restenosis in humans has not been evaluated. We found that angiographic restenosis is associated with an increase in circulating CD34+ cells 1 day after stent placement. Furthermore, we found a positive correlation between the postprocedural increase in circulating CD34+ cells and
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Cited by (55)
Systemic application of sirolimus prevents neointima formation not via a direct anti-proliferative effect but via its anti-inflammatory properties
2017, International Journal of CardiologyCitation Excerpt :Therefore, the reduced re-endothelialization observed in our in vivo experiments after systemic sirolimus treatment is very likely due to a reduced expression of adhesion molecules and subsequently reduced recruitment of leukocytes and BMPC, which under normal conditions would support endothelial regeneration by the local secretion of growth factors and cytokines. However, BMPC levels are also positively correlated with restenosis, indicating that there is no specific effect of BMPC on re-endothelialization alone [15,37]. In a previous report using a model of wire-induced injury in mice, the local application of sirolimus around the injured vessel segment resulted in a reduced accumulation and differentiation of BMPC into SM-like cells within neointimal lesions [8].
CD34 affinity pheresis attenuates a surge among circulating progenitor cells following vascular injury
2014, Journal of Vascular SurgeryCitation Excerpt :In some ways, the surge of CD34 progenitors is not unexpected, given the role of these cells in the repair of endothelial injury.29 With regards to intimal pathology, however, previous human studies have demonstrated that patients with increased numbers of preprocedural17 and postprocedural16,33 CD34 positive progenitors carry statistically higher risk for coronary restenosis. The short longitudinal study of Inoue et al33 among human coronary stent patients revealed both increases among CD34 cells but also an increase of mobilization cytokines such as G-CSF, suggesting these CD34+ cells originate from the bone marrow reservoir.
Smooth Muscle Progenitor Cells: A Novel Target for the Treatment of Vascular Disease?
2012, Muscle: Fundamental Biology and Mechanisms of DiseaseEndothelial Progenitor Cells in Coronary Artery Disease: From Bench to Bedside
2022, Stem Cells Translational Medicine
This study was supported by Deutsche Forschungsgemeinschaft (grants WE1913/7-1 and SCHO1056/2-1), Bonn, Germany.