Migratory activity of circulating progenitor cells and serum SDF-1? predict adverse events in patients with myocardial infarction.

Aims: Following an acute myocardial infarction (AMI), pro-angiogenic PCs are released from the bone marrow into the circulation and home to the ischemic site attracted by a chemokine gradient. It is unknown if components of this early homeostatic response might help forecast long-term clinical outcome. This study investigates if the number and migratory activity of circulating progenitor cells (PCs) predicts adverse events in patients with AMI (clinical trial: NCT01271309). Methods and Results: Basal counts and in vitro migratory activity of CD34/CD45/CD133/CXCR4 PCs and serum cytokine levels were assessed during the first 5 days after AMI in a consecutive series of 172 patients. Clinical outcomes of the study were death, repeat AMI, and new-onset heart failure at 1-year follow-up. The association of PC counts and cytokine levels with the incidence of clinical outcomes was assessed by multivariable regression models. AMI patients who underwent an event showed higher serum SDF-1a levels and reduced spontaneous motility of PCs in an in vitro migration assay compared with event-free subjects. After adjustment for age, gender, presence or absence of ST elevation or diabetes, the percentage of PCs non-migrated towards vehicle or SDF-1a were both independent predictors of death or repeat AMI or new-onset heart failure (odds ratio [OR] 2, p=0.015. and OR 1.90, p=0.018, respectively). Moreover, serum SDF-1a levels predict adverse events (OR 3.8, p=0.007). Conclusion: Biomarkers reflecting the migratory activity of circulating PCs may aid the assessment of secondary risk in AMI patients.