Percutaneous coronary intervention causes a rapid but transient mobilisation of CD34⁺CD45⁻cells

Abstract

ObjectiveCirculating CD34+CD45− cell concentrations are increased in patients with coronary artery disease, however their pathophysiological significance is unknown. We determined CD34+CD45− cell concentrations following percutaneous coronary intervention (PCI) in order to explore their role in acute vascular injury.MethodsIn a prospective time-course analysis, we quantified using flow cytometry circulating CD34+CD45− cells, traditional CD34+VEGFR-2+ putative endothelial progenitor cells (EPCs), CD14+ VEGFR− 2+Tie-2+ angiogenic monocytes and intercellular adhesion molecule expression (CXCR-4 and CD18) in patients, before and during the first week following diagnostic angiography (n=13) or PCI (n=23). Vascular endothelial growth factor-A (VEGF-A) and C reactive protein (CRP) were quantified by ELISA.ResultsUnlike diagnostic angiography, PCI increased circulating neutrophil and CRP concentrations at 24 and 48 h, respectively (p<0.002 for both). CD34+CD45− cell concentrations were unaffected by angiography (p>0.4), but were transiently increased 6 h following PCI (median (IQR) 0.93 (0.43–1.49) vs 1.51 (0.96–2.15)×106 cells/L; p=0.01), returning to normal by 24 h.This occurred in the absence of any change in serum VEFG-A concentration, adhesion molecule expression on CD34+ cells, or mobilisation of traditional EPCs or angiogenic monocytes (p>0.1 for all).ConclusionsPCI transiently increases circulating CD34+CD45− cells, without increasing CD34+ adhesion molecule expression or VEGF-A concentrations, suggesting that CD34+CD45− cells may be mobilised from the vessel wall directly as a result of mechanical injury. Traditional putative EPC and angiogenic monocytes are unaffected by PCI, and are unlikely to be important in the acute response to vascular injury.

Endothelial Progenitor Cell Biology and Vascular Recovery Following Transradial Cardiac Catheterization

“…24 Mobilization of CD34 + and CD133 + cells has been reported previously in response to large nonspecific inflammatory insults [25][26][27] and myocardial infarction 28,29 whereas cellular response to discrete vascular injury is less readily demonstrable. 30,31 Acute mobilization of CD34 + populations has, however, been described after PCI, with higher concentrations predicting restenosis. 28,32 Alongside the disappointing injury.…”

Systemic Inflammation after Transradial Coronary Angiogram: Statistically (But Not Clinically) Significant?

“…Only rare studies are available on inflammatory answer in patients with coronary angiogram without PCI. In a study on only 13 patients without PCI, CRP was unchanged by contrast with patients with PCI (n=23; P<0.002) [12] . In another small study, CRP as well as other inflammatory proteins elevated 24 and 48 hours after PCI in 40 patients with stable angina [13] .…”

Endothelial progenitor cells mobilisation after percutaneous coronary intervention: a pilot study

“…This partially agrees with Padfield et al that described the same kinetics for circulating CD34+, CD45− cells, but not for CD34+, KDR+ cells. [17] More recently, Gao et al have found the same EPC kinetics than us during the first 24 h post-PCI for CD133+, CD34+, KDR+ cells. [18] They also described that EPC mobilisation is influenced by the degree of endothelial injury.…”