Circulating Progenitor Cells in Patients With Coronary Artery Disease and Renal Insufficiency

• Type of Material: Article
• Authors: Anurag Mehta, Emory University; Ayman S. Tahhan, Emory University; Chang Liu, Emory University; Devinder S. Dhindsa, Emory University; Aditi Nayak, Emory University; Ananya Hooda, Emory University; Kasra Moazzami, Emory University; Shabatun J. Islam, Emory University; Steven C. Rogers, Emory University; Zakaria Almuwaqqat, Emory University; Ali Mokhtari, Emory University; Iraj Hesaroieh, Emory University; Yi-An Ko, Emory University; Edmund Waller, Emory University; Arshed Quyyumi, Emory University
• Language: English
• Date: 2020-08-01
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2020 The Authors
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.jacbts.2020.06.006
• Title of Journal or Parent Work: JACC: Basic to Translational Science
• Volume: 5
• Issue: 8
• Start Page: 770
• End Page: 782
• Grant/Funding Information: Dr. Quyyumi is supported by National Institutes of Health grants 1P20HL113451-01, 1R61HL138657-02, 1P30DK111024-03S1, 5R01HL095479-08, 3RF1AG051633-01S2, 5R01AG042127-06, 2P01HL086773-08, U54AG062334-01, 1R01HL141205-01, 5P01HL101398-02, 1P20HL113451-01, 5P01HL086773-09 1RF1AG051633-01, R01 NS064162-01, R01 HL89650-01, HL095479-01, 1DP3DK094346-01, and 2P01HL086773 and American Heart Association grant 15SFCRN23910003.; Dr. Mehta is supported by American Heart Association postdoctoral fellowship award 19POST34400057.; Drs. Mehta, Tahhan, Dhindsa have been supported by the Abraham J. and Phyllis Katz Foundation (Atlanta, Georgia).
• Keywords: CXCR4, chemokine (C-X-C motif) receptor 4; outcomes; regenerative capacity; hsTnI, high-sensitivity troponin I; CD, cluster of differentiation; IDI, integrated discrimination index; CI, confidence interval; CAD, coronary artery disease; BNP, B-type natriuretic peptide; CPC, circulating progenitor cell; HR, hazard ratio; VEGF2R, vascular endothelial growth factor receptor 2; renal insufficiency; progenitor cells; CV, cardiovascular; eGFR, estimated glomerular filtration rate; MI, myocardial infarction; coronary artery disease
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Patients with coronary artery disease and renal insufficiency (RI) (estimated glomerular filtration rate <60 ml/min/1.73 m2) are at an increased risk of cardiovascular events. The contribution of regenerative capacity, measured as circulating progenitor cell (CPC) counts, to this increased risk is unclear. CPCs were enumerated as cluster of differentiation (CD) 45med+ mononuclear cells expressing CD34+, CD133+, CXCR4+ (chemokine [C-X-C motif] receptor 4), and VEGF2R+ (vascular endothelial growth factor receptor 2) epitopes in 1,281 subjects with coronary artery disease (35% with RI). Patients with RI and low (<median) hematopoietic CPCs (CD34+, CD34+/CD133+, and CD34+/CXCR4+) were at an increased risk of cardiovascular death or myocardial infarction events (hazard ratios: 1.75 to 1.80) during 3.5-year follow-up, while those with RI and high CPCs (>median) were at a similar risk as those without RI.