Circulating Progenitor Cells and Coronary Collaterals in Chronic Total Occlusion

Daniel A Gold; Pratik B Sandesara; Bryan Kindya; Matthew E Gold; Vardhmaan Jain; Nishant Vatsa; Shivang R Desai; Adithya Yadalam; Alexander Razavi; Malika Elhage Hassan; Yi-An Ko; Chang Liu; Ayman Alkhoder; Alireza Rahbar; Mohammad S Hossain; Edmund K Waller; Wissam A Jaber; William J Nicholson; Arshed A Quyyumi

doi:10.1016/j.ijcard.2024.132104

Circulating Progenitor Cells and Coronary Collaterals in Chronic Total Occlusion

Int J Cardiol. 2024 Apr 25:407:132104. doi: 10.1016/j.ijcard.2024.132104. Online ahead of print.

Authors

Daniel A Gold¹, Pratik B Sandesara¹, Bryan Kindya¹, Matthew E Gold¹, Vardhmaan Jain¹, Nishant Vatsa¹, Shivang R Desai¹, Adithya Yadalam¹, Alexander Razavi¹, Malika Elhage Hassan¹, Yi-An Ko², Chang Liu³, Ayman Alkhoder¹, Alireza Rahbar¹, Mohammad S Hossain⁴, Edmund K Waller⁴, Wissam A Jaber¹, William J Nicholson¹, Arshed A Quyyumi⁵

Affiliations

¹ Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
² Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia.
³ Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia.
⁴ Division of Hematology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
⁵ Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia. Electronic address: aquyyum@emory.edu.

PMID: 38677332
DOI: 10.1016/j.ijcard.2024.132104

Abstract

Background: The role of circulating progenitor cells (CPC) in collateral formation that occurs in the presence of chronic total occlusions (CTO) of a coronary artery is not well established. In stable patients with a CTO, we investigated whether CPC levels are associated with (a) collateral development and (b) ischemic burden, as measured by circulating high sensitivity troponin-I (hsTn-I) levels.

Methods: CPCs were enumerated by flow cytometry as CD45^med+ blood mononuclear cells expressing CD34 and both CD34 and CD133 epitopes. The association between CPC counts and both Rentrop collateral grade (0, 1, 2, or 3) and hsTn-I levels were evaluated using multivariate regression analysis, after adjusting for demographic and clinical characteristics.

Results: In 89 patients (age 65.5, 72% male, 27% Black), a higher CPC count was positively associated with a higher Rentrop collateral grade; [CD34+ adjusted odds ratio (OR) 1.49 95% confidence interval (CI) (0.95, 2.34) P = 0.082] and [CD34+/CD133+ OR 1.57 95% CI (1.05, 2.36) P = 0.028]. Every doubling of CPC counts was also associated with lower hsTn-I levels [CD34+ β -0.35 95% CI (-0.49, -0.15) P = 0.002] and [CD34+/CD133+ β -0.27 95% CI (-0.43, -0.08) P = 0.009] after adjustment.

Conclusion: Individuals with higher CPC counts have greater collateral development and lower ischemic burden in the presence of a CTO.

Keywords: Chronic Total occlusion; Circulating progenitor cell; Collaterals.