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Int J Cardiol. 2020 Nov 01;318:123-125. doi: 10.1016/j.ijcard.2020.06.002. Epub 2020 Jun 06.

Endothelial progenitor cells predict long-term outcome in patients with coronary artery disease: Ten-year follow-up of the PROCREATION extended study.

International journal of cardiology

Francesco Pelliccia, Vincenzo Pasceri, Andrea Moretti, Gaetano Tanzilli, Giulio Speciale, Carlo Gaudio


  1. Department of Cardiovascular Sciences, Sapienza University, Rome, Italy. Electronic address: [email protected].
  2. Interventional Cardiology Unit, San Filippo Neri Hospital, Rome, Italy.
  3. Department of Cardiovascular Sciences, Sapienza University, Rome, Italy.

PMID: 32522679 DOI: 10.1016/j.ijcard.2020.06.002


BACKGROUND: Levels of circulating endothelial progenitor cells (EPCs) are associated with the short-term prognosis of patients with coronary artery disease (CAD). No previous study, however, has ascertained if EPCs are related also to long-term outcome. We performed a pre-specified analysis of the PROCREATION (PROgenitor Cells role in Restenosis and progression of coronary ATherosclerosis after percutaneous coronary intervention) study in order to assess if EPCs predict the 10-year prognosis.

METHODS AND RESULTS: Consecutive stable patients with CAD who were included in the PROCREATION study were evaluated. Patients underwent an extended 10-year follow-up to assess major adverse cardiac or cerebrovascular events (MACCE), i.e. death, stroke, myocardial infarction, and revascularization. During follow-up, MACCE occurred in 79 of 149 patients (53%). Most clinical and angiographic baseline variables were similar in patients with or without MACCE, apart from age, diabetes, chronic kidney disease, ejection fraction, and extent of CAD. Comparison of EPCs, conversely, showed that patients with MACCE had greater levels of CD34+/KDR+/CD45- cells (p=0.0002) and CD133+/KDR+/CD45- cells (p=0.0001). Multivariate analysis showed that factors independently associated with 10-year MACCEs were age (p=0.001), ejection fraction (p=0.018), and CD34+/KDR+/CD45- cells (p=0.024).

CONCLUSION: Subpopulations of EPCs can improve long-term risk factor characterization in patients with CAD. (ClinicalTrials.gov: NCT01575431).

Copyright © 2020. Published by Elsevier B.V.

Keywords: Endothelial progenitor cells; ischemic heart disease; prognosis

Conflict of interest statement

Declaration of Competing Interest The authors report no conflict of interest.

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