This Article Full Text Full Text (PDF) All Versions of this Article: 110/12/1586    most recent 01.CIR.0000142295.85740.98v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Quilici, J. Articles by Dignat-George, F. Search for Related Content PubMed PubMed Citation Articles by Quilici, J. Articles by Dignat-George, F. Pubmed/NCBI databases Substance via MeSH Related Collections Acute coronary syndromes Other diagnostic testing Endothelium/vascular type/nitric oxide

(Circulation. 2004;110:1586-1591.)
© 2004 American Heart Association, Inc.

Coronary Heart Disease

Circulating Endothelial Cell Count as a Diagnostic Marker for Non–ST-Elevation Acute Coronary Syndromes

Jacques Quilici, MD; Nathalie Banzet, PhD; Philippe Paule, MD; Jean-Baptiste Meynard, MD; Murielle Mutin, PhD; Jean-Louis Bonnet, MD; Pierre Ambrosi, PhD; José Sampol, PhD; Françoise Dignat-George, PhD

From the Département de Cardiologie (J.Q., P.P., J.-L.B., P.A.), Hôpital Timone Adultes; INSERM U608 (N.B., M.M., P.A., J.S., F.D.-G.), Laboratoire d’Immunologie et d’Hématologie, UFR de Pharmacie, Université de la Méditerranée; and Département d’Epidémiologie et de Santé Publique (J.-B.M.), IMTSSA, Marseille, France.

Correspondence to F. Dignat-George, Laboratoire d’Immunologie et d’Hématologie, UFR de Pharmacie, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France. E-mail dignat{at}pharmacie.univ-mrs.fr

Received September 18, 2003; de novo received February 24, 2004; accepted May 20, 2004.

Background— Shedding of endothelial cells from damaged endothelium into the blood occurs in a variety of vascular disorders. The purpose of this study was to evaluate the utility of circulating endothelial cell (CEC) count as a diagnostic marker of non–ST-elevation acute coronary syndromes (ACSs).

Methods and Results— CEC counts were determined immediately (H0), 4 hours (H4), and 8 hours (H8) after admission in 60 patients with documented non–ST-elevation ACS and 40 control patients with no evidence of coronary artery disease. A total of 32 patients in the ACS group had elevated CEC counts (>3 cells/mL) in relation to early admission and single-episode chest pain. Patients from the control group had normal CEC counts. The interval between the chest pain episode and elevation was significantly shorter for CEC than troponin I. No correlation was found between the 2 markers. Interestingly, a subgroup of ACS patients with initially normal troponin I levels had high CEC counts, thus allowing early diagnosis in 30% more cases. At H0, the mean area under the receiver operating characteristic curve was significantly higher with the CEC count than with the troponin I level. At H4 and H8, the combined use of CEC and troponin was significantly better as a marker of ACS than CEC alone or troponin I alone.

Conclusions— This study demonstrates that CEC count can be used as an early, specific, independent diagnostic marker for non–ST-elevation ACS. A combined strategy using CEC count and troponin I level could provide an effective diagnostic tool.

Key Words: acute coronary syndromes • atherosclerosis • diagnosis • endothelium

This article has been cited by other articles:

				C. J. Boos, S. K. Soor, D. Kang, and G. Y.H. Lip Relationship between circulating endothelial cells and the predicted risk of cardiovascular events in acute coronary syndromes Eur. Heart J., May 1, 2007; 28(9): 1092 - 1101. [Abstract] [Full Text] [PDF]

				C. J. Boos, G. Y.H. Lip, and A. D. Blann Circulating Endothelial Cells in Cardiovascular Disease J. Am. Coll. Cardiol., October 17, 2006; 48(8): 1538 - 1547. [Abstract] [Full Text] [PDF]

				M. R. Cesarone, G. Belcaro, L. Pellegrini, A. Ledda, G. Vinciguerra, A. Ricci, G. Gizzi, E. Ippolito, F. Fano, M. Dugall, et al. Circulating Endothelial Cells in Venous Blood as a Marker of Endothelial Damage in Chronic Venous Insufficiency: Improvement with Venoruton Journal of Cardiovascular Pharmacology and Therapeutics, March 1, 2006; 11(1): 93 - 99. [Abstract] [PDF]

				A Gaspardone, F Menghini, V Mazzuca, O Skossyreva, G Barbato, and P de Fabritiis Progenitor cell mobilisation in patients with acute and chronic coronary artery disease Heart, February 1, 2006; 92(2): 253 - 254. [Full Text] [PDF]

				D. A. Ingram, N. M. Caplice, and M. C. Yoder Unresolved questions, changing definitions, and novel paradigms for defining endothelial progenitor cells Blood, September 1, 2005; 106(5): 1525 - 1531. [Abstract] [Full Text] [PDF]