Background Circulating endothelial progenitor cells (EPC) are increased in conditions associated with ischemia and can potentially support angiogenesis and vasculogenesis. EPC levels were also shown to predict outcome in patients with atherosclerotic vascular disease. We tested the hypothesis that circulating EPC can predict outcome in patients with congestive heart failure (CHF).
Methods and Results EPC- colony forming units (CFU) were measured in the peripheral blood of 107 consecutive CHF patients with New York Heart Association functional class (NYHA) II-IV. Serum levels of vascular endothelial growth factor (VEGF), N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) and high sensitivity C-reactive protein (hsCRP) were also measured. End points were defined as CHF related hospitalizations and all-cause mortality. Age (p=0.01), diabetes mellitus (p=0.002) and EPC levels (p=0.02) were found to be independent predictors of all-cause mortality. EPC levels did not predict CHF related hospitalizations. EPC levels correlated positively with NYHA (p=0.05, r=0.19) but did not correlate with VEGF, NT-pro-BNT or hsCRP. EPC levels did not differ by the etiology of CHF.
Conclusions EPC levels are independent predictors of all-cause mortality among CHF patients.
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