Objective: To investigate the spontaneous occurrence of circulating mesenchymal stem cells (MSC) and angiogenic factors in patients with ST elevation acute myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI).
Design: In 20 patients with STEMI, blood samples were obtained on days 1, 3, 7, 14, 21, and 28 after the acute PCI. Fifteen patients with a normal coronary angiography formed a control group. MSC (CD45−/CD34−), plasma stromal derived factor 1 (SDF-1), vascular endothelial growth factor A (VEGF-A), and fibroblast growth factor 2 (FGF-2) were measured by multiparametric flow cytometry and enzyme linked immunosorbent assay (ELISA).
Results: Circulating CD45−/CD34− cells were significantly decreased on day 7 compared with day 3. Cell counts normalised one month after the acute onset of STEMI. The changes were mainly seen in patients with a large infarction. Plasma SDF-1 increased significantly from day 3 to day 28, and VEGF-A and FGF-2 increased significantly from day 7 to day 28.
Conclusions: Spontaneous sequential fluctuations in MSC and the increase in vascular growth factor concentrations after STEMI suggest that the optimal time for additional stem cell therapy is three weeks after a myocardial infarction to obtain the maximum effects by stimulating endogenous growth factors on the delivered stem cells.
- CK, creatine kinase
- CXCR-4, CXC chemokine receptor 4
- ELISA, enzyme linked immunosorbent assay
- FGF-2, fibroblast growth factor 2
- MSC, mesenchymal stem cells
- PCI, percutaneous coronary intervention
- PECAM-1, platelet endothelial cell adhesion molecule 1
- SDF-1, stromal derived factor 1
- STEMI, ST elevation acute myocardial infarction
- TIMI, thrombolysis in myocardial infarction
- VEGF, vascular endothelial growth factor
- stem cell
- acute myocardial infarction
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