Characterization of Circulating Endothelial Cells in Acute Myocardial Infarction
| Autor: | Eric J. Topol, Aparajita H. Chourasia, Kelly Bethel, Andrea Bacconi, Chandra Rao, Rod Serry, Ondrej Libiger, Samir Damani, Bridget Carragher, Peter Kuhn, Sharon Haaser, Sharen Knowlton, Raghava R. Gollapudi, Malcolm R. Wood, Ron Goldberg, John Jiang, Velia M. Fowler, Nicholas J. Schork, Mark Connelly, Kevin Rapeport, Sarah E. Topol |
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| Rok vydání: | 2012 |
| Předmět: |
Adult
Male Pathology medicine.medical_specialty Necrosis Myocardial Infarction Cell Count Creatine Article Coronary artery disease chemistry.chemical_compound Cell Movement medicine Humans Myocardial infarction Cell Shape Aged Cell Size Aged 80 and over Cell Nucleus biology Vascular disease business.industry Case-control study Endothelial Cells Arteries General Medicine Middle Aged medicine.disease Troponin Peripheral Phenotype Microscopy Fluorescence chemistry Case-Control Studies cardiovascular system biology.protein Female medicine.symptom business Biomarkers |
| Zdroj: | Science Translational Medicine. 4 |
| ISSN: | 1946-6242 1946-6234 |
| DOI: | 10.1126/scitranslmed.3003451 |
| Popis: | Acute myocardial infarction (MI), which involves the rupture of existing atheromatous plaque, remains highly unpredictable despite recent advances in the diagnosis and treatment of coronary artery disease. Accordingly, a clinical measurement that can predict an impending MI is desperately needed. Here, we characterize circulating endothelial cells (CECs) using an automated and clinically feasible CEC three-channel fluorescence microscopy assay in 50 consecutive patients with ST-segment elevation MI and 44 consecutive healthy controls. CEC counts were significantly elevated in MI cases versus controls, with median numbers of 19 and 4 cells/ml, respectively (P = 1.1 × 10(-10)). A receiver-operating characteristic (ROC) curve analysis demonstrated an area under the ROC curve of 0.95, suggesting near-dichotomization of MI cases versus controls. We observed no correlation between CECs and typical markers of myocardial necrosis (ρ = 0.02, creatine kinase-myocardial band; ρ = -0.03, troponin). Morphological analysis of the microscopy images of CECs revealed a 2.5-fold increase (P < 0.0001) in cellular area and a twofold increase (P < 0.0001) in nuclear area of MI CECs versus healthy controls, age-matched CECs, as well as CECs obtained from patients with preexisting peripheral vascular disease. The distribution of CEC images that contained from 2 to 10 nuclei demonstrates that MI patients were the only subject group to contain more than 3 nuclei per image, indicating that multicellular and multinuclear clusters are specific for acute MI. These data indicate that CEC counts may serve as a promising clinical measure for the prediction of atherosclerotic plaque rupture events. |
| Databáze: | OpenAIRE |
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