Author + information
- Received April 27, 2020
- Revision received June 4, 2020
- Accepted June 6, 2020
- Published online August 24, 2020.
- Anurag Mehta, MDa,∗,
- Ayman S. Tahhan, MDa,∗,
- Chang Liu, MPHa,b,
- Devinder S. Dhindsa, MDa,
- Aditi Nayak, MDa,
- Ananya Hooda, MBBSa,
- Kasra Moazzami, MD, MPHa,
- Shabatun J. Islam, MDa,
- Steven C. Rogers, MD, PhDa,
- Zakaria Almuwaqqat, MDa,
- Ali Mokhtari, MDa,
- Iraj Hesaroieh, MDa,
- Yi-An Ko, PhDa,c,
- Edmund K. Waller, MD, PhDd and
- Arshed A. Quyyumi, MDa,∗ ()
- aEmory Clinical Cardiovascular Research Institute, Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- bDepartment of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
- cDepartment of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia
- dDepartment of Hematology and Oncology, Winship Cancer Institute, Emory University School of Medicine, Atlanta, Georgia
- ↵∗Address for correspondence:
Dr. Arshed A. Quyyumi, Division of Cardiology, Emory University School of Medicine, Emory Clinical Cardiovascular Research Institute, 1462 Clifton Road Northeast, Suite 507, Atlanta, Georgia 30322.
• Patients with CAD and renal insufficiency (eGFR <60 ml/min/1.73 m2) are at an increased risk of adverse outcomes.
• CPC counts, an index of endogenous vascular regenerative capacity, may help stratify risk in patients with CAD and renal insufficiency.
• Renal insufficiency is associated with lower CPC counts in old, but not young, patients with established CAD.
• The increased risk of adverse outcomes with CAD and renal insufficiency is limited to patients with low, but not high, CPC counts.
Patients with coronary artery disease and renal insufficiency (RI) (estimated glomerular filtration rate <60 ml/min/1.73 m2) are at an increased risk of cardiovascular events. The contribution of regenerative capacity, measured as circulating progenitor cell (CPC) counts, to this increased risk is unclear. CPCs were enumerated as cluster of differentiation (CD) 45med+ mononuclear cells expressing CD34+, CD133+, CXCR4+ (chemokine [C-X-C motif] receptor 4), and VEGF2R+ (vascular endothelial growth factor receptor 2) epitopes in 1,281 subjects with coronary artery disease (35% with RI). Patients with RI and low (<median) hematopoietic CPCs (CD34+, CD34+/CD133+, and CD34+/CXCR4+) were at an increased risk of cardiovascular death or myocardial infarction events (hazard ratios: 1.75 to 1.80) during 3.5-year follow-up, while those with RI and high CPCs (>median) were at a similar risk as those without RI.
↵∗ Drs. Mehta and Tahhan contributed equally to this work and are joint first authors.
Drs. Mehta, Tahhan, Dhindsa have been supported by the Abraham J. and Phyllis Katz Foundation (Atlanta, Georgia). Dr. Mehta is supported by American Heart Association postdoctoral fellowship award 19POST34400057. Dr. Quyyumi is supported by National Institutes of Health grants 1P20HL113451-01, 1R61HL138657-02, 1P30DK111024-03S1, 5R01HL095479-08, 3RF1AG051633-01S2, 5R01AG042127-06, 2P01HL086773-08, U54AG062334-01, 1R01HL141205-01, 5P01HL101398-02, 1P20HL113451-01, 5P01HL086773-09 1RF1AG051633-01, R01 NS064162-01, R01 HL89650-01, HL095479-01, 1DP3DK094346-01, and 2P01HL086773 and American Heart Association grant 15SFCRN23910003. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC: Basic to Translational Science author instructions page.
- Received April 27, 2020.
- Revision received June 4, 2020.
- Accepted June 6, 2020.
- 2020 The Authors