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Circulating endothelial progenitor cells and the risk of vascular events after ischemic stroke.

2015, PLoS One. 2015 Apr 13;10(4):e0124895. doi: 10.1371/journal.pone.0124895. eCollection 2015.
Martí-Fàbregas J1, Delgado-Mederos R1, Crespo J2, Peña E2, Marín R1, Jiménez-Xarrié E1, Fernández-Arcos A1, Pérez-Pérez J1, Martínez-Domeño A1, Camps-Renom P1, Prats-Sánchez L1, Casoni F1, Badimon L2.
Autors del centre relacionats: Badimon Lina, Crespo Javier, Peña Esther.
1Department of Neurology, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain.
2Cardiovascular Research Center, Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, Spain.
We evaluated the hypothesis that the number of circulating EPC could be associated with the risk of stroke recurrence (SR) or vascular events (VE) after an ischemic stroke.
We studied prospectively consecutive patients with cerebral infarction within the first 48 hours after the onset. We recorded demographic factors, vascular risk factors, previous Rankin scale (RS) score, and etiology. We analyzed EPC counts by flow cytometry in blood collected at day 7 and defined EPC as CD34+/CD133+/KDR+ cells. Mean follow-up was 29.3 ± 16 months. We evaluated SR as well as VE. Patients were classified as to the presence or absence of EPC in the circulation (either EPC+ or EPC-). Bivariate analyses, Kaplan-Meier survival curves and Cox regression models were used.
We included 121 patients (mean age 70.1±12.6 years; 65% were men). The percentage of EPC+ patients was 47.1%. SR occurred in 12 (9.9%) and VE in 18 (14.9%) patients. SR was associated significantly with a worse prior RS score, previous stroke and etiology, but not with EPC count. VE were associated significantly with EPC-, worse prior RS score, previous stroke, high age, peripheral artery disease and etiology. Cox regression model showed that EPC- (HR 7.07, p=0.003), age (HR 1.08, p=0.004) and a worse prior RS score (HR 5.8, p=0.004) were associated significantly with an increased risk of VE.
The absence of circulating EPC is not associated with the risk of stroke recurrence, but is associated with an increased risk of future vascular events.
PMID: 25874380 [PubMed - in process] PMCID: PMC4395144

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