Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty

Summary

Development of major adverse cardiovascular events, which impact cardiovascular prognosis after coronary angioplasty, are influenced by the extent of coronary damage and vascular repair. The use of novel coronary cellular and soluble biomarkers, reactive to vascular damage and repair, are useful to predict the development of MACEs and prognosis.

Abstract

Major adverse cardiovascular events (MACEs) negatively impact the cardiovascular prognosis of patients undergoing coronary angioplasty due to coronary ischemic injury. The extent of coronary damage and the mechanisms of vascular repair are factors influencing the future development of MACEs. Intrinsic vascular features like the plaque characteristics and coronary artery complexity have demonstrated prognostic information for MACEs. However, the use of intracoronary circulating biomarkers has been postulated as a convenient method for the early identification and prognosis of MACEs, as they more closely reflect dynamic mechanisms involving coronary damage and repair. Determination of coronary circulating biomarkers during angioplasty, such as the number of subpopulations of mononuclear progenitor cells (MPCs) as well as the concentration of soluble molecules reflecting inflammation, cell adhesion, and repair, allows for assessment of future developments and the prognosis of MACEs 6 months post coronary angioplasty. This method is highlighted by its translational nature and better performance than peripheral blood circulating biomarkers regarding prediction of MACEs and its effect on the cardiovascular prognosis, which may be applied for risk stratification of patients with coronary artery disease undergoing angioplasty.

Introduction

Coronary angioplasty and stenting represent a salvage procedure for patients with coronary artery disease (CAD). However, major adverse cardiovascular events (MACEs), including cardiovascular death, myocardial infarction, coronary restenosis, and episodes of angina or decompensate heart failure, may occur months after coronary intervention, prompting unscheduled visits to the hospital. MACEs are common worldwide and their morbi-mortality is high¹.

Coronary ischemic injury induces early vascular response and reparative mechanisms involving mobilization of MPCs due to their differentiation ability and/or angio-reparati....

Protocol

This protocol meets the institutional guidelines from the human research Ethics Committee.

1. Coronary Angiography, Ultrasound, and Blood Sampling

1. Request baseline clinical and demographic information before coronary intervention. Collect the individual's data: age, sex, current smoking status, body mass index (BMI), high blood pressure, dyslipidemia, diabetes mellitus, medications, and the indication for current coronary angiography.
2. Perform coronary angiography thro.......

Discussion

Blood collection from the affected coronary artery may be difficult. Sometimes, the coronary artery is barely accessible. In this case, sampling from the venous sinus may be an alternative. We performed validation tests comparing circulating biomarkers in coronary artery vs. venous sinus, with no significant differences. However, the performance of circulating biomarkers was validated only for coronary sampling. Therefore, the performance of biomarkers obtained from the venous sinus remains to be explored.

Materials

Name	Company	Catalog Number	Comments
BSA	Roche	10735086001	Bovine Serum Albumin (BSA) as a buffering agent, stabilizer, standard and for blending.
Calibration Beads	Miltenyi Biotec / MACS	#130-093-607	MACQuant calibration beads are supplied in aqueous solution containing 0.05% sodium azide. 3.5 ml for up to 100 tests
CD133/1 (AC133)-PE	Milteny Biotec / MACS	#130-080-801	Antibody conjugated to R-Phycoerythrin in PBS/EDTA buffer
CD184 (CXCR4)-PE-VIO770	Miltenyi Biotec / MACS	#130-103-798	Monoclonal, Isotype recombinant human IgG1, conjugated
CD309 (VEGFR-2/KDR)-APC	Miltenyi Biotec / MACS	#130-093-601	Antibody conjugated to R-Phycoerythrin in PBS/EDTA buffer
CD34-FITC	Miltenyi Biotec / MACS	#130-081-001	The monoclonal antibody clone AC136 detecs a class III epitope of the CD34
CD45- VioBlue	Miltenyi Biotec / MACS	#130-092-880	Monoclonal CD45 Antibody, human conjugated
Conical Tubes	Thermo SCIENTIFIC	#339651	15ml conical centrifuge tubes
Cytometry Tubes	FALCON Corning Brand	#352052	5 mL Polystyrene Round-Bottom Tube. 12x75 style. Sterile.
EDTA	BIO-RAD	#161-0729	Heavy metals, (as Pb) <10ppm, Fe <0.01%, As <1ppm, Insolubles <0.005%
Improved Neubauer	Without brand	Without catalog number	Hemocytometer for cell counting. (range 0.1000mm, 0.0025mm2)
K2 EDTA Blood Collection Tubes	BD Vacutainer	#367863	Lilac plastic vacutainer tube (K2E) 10.8mg, 6 mL.
Lymphoprep	Stemcell Technologies	01-63-12-002-A	Sterile and checked on the presence of endotoxins. Density: 1.077±0.001g/mL
Paraformaldehyde	SIGMA-ALDRICH	#SZBF0920V	Fixation of biological samples, (powder, 95%)
Pipette Transfer 1,3mL	CRM Globe	PF1016, PF1015	The transfer pipette is a tool that facilitates liquid transfer with greater accuracy.
Test Tubes	KIMBLE CHASE	45060 13100	Heat-resistant test tubes. SIZE/CAP 13 x 100 mm