Circulating CD34 progenitor cells and growth factors in patients treated with PCI for acute myocardial infarction or stable angina pectoris.

摘要

OBJECTIVE: To differentiate the effect of myocardial infarction from the effect of percutaneous coronary intervention (PCI) on the circulatory profiles of CD34(+) cells and growth factors in patients with ST-elevation myocardial infarction (STEMI). METHODS: Twenty patients with STEMI and 10 with angina pectoris (AP) were included. All were treated with PCI. Blood was drawn before PCI in the AP group, and after 3 and 12 hours, and 1, 3, 5, 7 and 14 days after PCI in both groups. In STEMI patients, correlation analyses between TIMI myocardial perfusion grade (TMP-grade) and circulating CD34(+) cells were also assessed. RESULTS: Circulating CD34(+) cells increased from day 1 to days 5 and 7 after PCI only in STEMI patients (p < 0.05). Between-group analyses revealed a borderline significant difference in change in SDF-1alpha concentrations from 3 h to 14 days after PCI (p = 0.05), and SDF-1alpha was significantly higher in STEMI patients 14 days after PCI (p < 0.05). In both groups, peak HGF concentrations were observed 3 h after PCI, whereas IGF-1 increased in AP patients only, 3 h after PCI (p < 0.005). TIMI perfusion grade was negatively correlated to the circulating number of CD34(+) cells 5 days after PCI (r =-0.69, p < 0.005). CONCLUSION: After PCI, STEMI patients have significantly higher numbers of circulating CD34(+) progenitor cells compared to patients with AP. STEMI results in a significant increase in SDF-1alpha after 14 days, and the increase at this time may indicate a favorable environment for progenitor cell therapy.