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Author Notes:

Corresponding author: A.A. Quyyumi. Emory Clinical Cardiovascular Research Institute, 1462 Clifton Road NE, Suite 507, Atlanta GA 30322, USA. E-mail address: aquyyum@emory.edu.

We would like to thank the members of the Emory Biobank Team, the Emory Clinical Cardiovascular Research Institute (ECCRI), and the Atlanta Clinical and Translational Science Institute for recruitment of participants, compilation of data, and preparation of samples.

Disclosures: Nothing to disclose. No relationship with industry exists.

Conflict of interest: None declared.


Research Funding:

Funding for collection and management of samples was received from the Robert W. Woodruff Health Sciences Center Fund (Atlanta, GA), Emory Heart and Vascular Center (Atlanta, GA), Katz Family Foundation Preventive Cardiology Grant (Atlanta, GA) and NIH Grant UL1 RR025008 from the Clinical and Translational Science Award program NIH grant R01HL089650-02.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Peripheral Vascular Disease
  • Cardiovascular System & Cardiology
  • Stromal cell-derived factor1 alpha
  • CXCL12
  • Coronary artery disease
  • Cardiovascular outcomes
  • RISK
  • STEM

Plasma stromal cell-derived factor 1 alpha/CXCL12 level predicts long-term adverse cardiovascular outcomes in patients with coronary artery disease

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Journal Title:



Volume 238, Number 1


, Pages 113-118

Type of Work:

Article | Post-print: After Peer Review


Objective: Stromal derived factor-1α/CXCL12 is a chemoattractant responsible for homing of progenitor cells to ischemic tissues. We aimed to investigate the association of plasma CXCL12 with long-term cardiovascular outcomes in patients with coronary artery disease (CAD). Methods: 785 patients aged: 63±12 undergoing coronary angiography were independently enrolled into discovery (N=186) and replication (N=599) cohorts. Baseline levels of plasma CXCL12 were measured using Quantikine CXCL12 ELISA assay (R&D systems). Patients were followed for cardiovascular death and/or myocardial infarction (MI) for a mean of 2.6yrs. Cox proportional hazard was used to determine independent predictors of cardiovascular death/MI. Results: The incidence of cardiovascular death/MI was 13% (N=99). High CXCL12 level based on best discriminatory threshold derived from the ROC analysis predicted risk of cardiovascular death/MI (HR=4.81, p=1×10-6) independent of traditional risk factors in the pooled cohort. Addition of CXCL12 to a baseline model was associated with a significant improvement in c-statistic (AUC: 0.67-0.73, p=0.03). Addition of CXCL12 was associated with correct risk reclassification of 40% of events and 10.5% of non-events. Similarly for the outcome of cardiovascular death, the addition of the CXCL12 to the baseline model was associated with correct reclassification of 20.7% of events and 9% of non-events. These results were replicated in two independent cohorts. Conclusion: Plasma CXCL12 level is a strong independent predictor of adverse cardiovascular outcomes in patients with CAD and improves risk reclassification.

Copyright information:

© 2014 Elsevier Ireland Ltd.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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