Background Shedding of endothelial cells from damaged endothelium into the bl ood occurs in a variety of vascular disorders. The purpose of this study was to evaluate the utility of circulating endothelial cell (CEC) count as a diagnostic marker of non ST elevation acute coronary syndromes(ACSs). Methods and Result s CEC counts were determined immediately (H0), 4 hours (H4), and 8 hours (H8) a fter admission in 60 patients with documented non ST elevation ACS and 40 cont rol patients with no evidence of coronary artery disease. A total of 32 patients in the ACS group had elevated CEC counts (>3 cells/mL) in relation to early adm ission and single episode chest pain. Patients from the control group had norma l CEC counts. The interval between the chest pain episode and elevation was sign ificantly shorter for CEC than troponin I. No correlation was found between the 2 markers. Interestingly, a subgroup of ACS patients with initially normal tropo nin I levels had high CEC counts, thus allowing early diagnosis in 30%more case s. At H0, the mean area under the receiver operating characteristic curve was si gnificantly higher with the CEC count than with the troponin I level. At H4 and H8, the combined use of CEC and troponin was significantly better as a marker of ACS than CEC alone or troponin I alone. Conclusions This study demonstrates th at CEC count can be used as an early, specific, independent diagnostic marker fo r non ST elevation ACS. A combined strategy using CEC count and troponin I lev el could provide an effective diagnostic tool.
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