The Relationship Between Mobilization Of Circulating Endothelial Progenitor Cells And Time Or Degree Of Injury From Angioplasty In Exertional Angina

Objectives :1. To investigate the influence of coronary artery angioplasty on the recruitment of circulating endothelial progenitor cell(EPCs) in angina pectoris patients.2. To observe the change magnitude of the main EPCs associated especially with endothelial injury degree from PCI procedure. Methods:66 patients treated by coronary stenting were enrolled in the PCI group, 17 patients with single angiography were into the control group.EPCs count in blood was measured by flow cytometry just before and at 1th, 3th,5th,7th, 24 th hour after angioplasty respectively in PCI group, and counted at three time points after angiography in control group. We assumed that the stent is cylindrical after deployment from stent-balloon. The surface area of the stent(perimeter * length) in contact with the vascular endothelium and the maximum stent inflation pressure were taken to be the surrogate of the severity of endothelial damage.Results:1. 66 patients treated by coronary stenting were enrolled in the PCI group, 17 patients with single angiography were into the control group. Partial differences between two groups include lesions character of coronary artery, incidence of diabetes and family coronary heart disease. The mean surface area of the stent deployed was 335.59 ± 234.99 mm2. Compared with baseline level in PCI group, a moderate and delayed increase of EPCs CD34+/KDR+ occurred at 24 th hour post balloon inflation.2. The CD133-/CD34+/KDR+ subpopulations showed a wave change at 3th, 7th and 24 th hour post PCI(p=0.016, p=0.01, p=0.032, p=0.048, respectively). The number of CD34+/KDR+cells did not show a statistical difference after cag in control group.3. An arch-line was displayed in CD133+/KDR+cells, the first decrease occurred at 3th hour and maintained constant till to 7th hour(p=0.003, p=0.013, p=0.033, respectively), then increased mildly to it’s baseline level at 24 th hour(p=0.084). The number of CD133+/KDR+cells did not show a statistical difference after cag in control group.4. CD34+cells in tset group increased at 7 hours,then increased at 24 h significantly,it increased after 24 h by 71.1% compared to 0h,and by 29% compared to 7h; a step-rise was found in CD34+/CD133+ cells till 24 h. however,the CD34+cells in control group did not show a statistical difference.5. KDR+cells of PCI group decreased 94% at 7 h compared to 0h(P<0.01), and the number of witch in 24 h is higher than that 7h,but no statistical difference was found; no statistical difference was found about KDR+cells after CAG in control group.6. The EPCs CD34+/KDR+ change magnitude correlated significantly with global damage index by partial correlation analysis(p<0.001). Conclusions:1. The results suggest that a time-dependent mobilization of EPCs might be initiated by PCI.2. The change magnitude of the main EPCs associated especially with endothelial injury degree from PCI procedure.3. Global injury integral plays a crucial role in CD34+/KDR+ EPCs motivation.4. Intensive and effective motivation initiated by area of stent strut with coronary endothelial and stent inflation pressure post-dilation may contribute to the reparation of endothelium caused by PCI,and then to some extent decrease the incidence of in-stent thrombosis or restenosis.