The association between circulating endothelial progenitor cells and outcome in different subtypes of acute ischemic stroke

Objectives: This study evaluated the relationship between serial changes in circulating endothelial progenitor cells (EPCs) and outcomes in patients with different subtypes of acute ischemic stroke (AIS). Methods: This prospective cohort study evaluated 65 patients with AIS, including 45 with small-vessel and 20 with large-vessel diseases. The circulating level of EPCs (CD133(+)/CD34(+) and KDR+/CD34(+) cells) was determined at different time points (within 48 h and on Days 7 and 30 post-stroke). For comparison, the EPC levels of 65 age-and sex-matched controls were also evaluated. Results: The levels of CD133(+)/CD34(+) and KDR+/CD34(+) EPCs were significantly lower in the AIS group than in the control group (p < 0.05). There were fewer CD133(+)/CD34(+) EPCs in the large-vessel disease group than in the small-vessel disease group on Day 1 post-stroke (p <0.05). After adjusting for covariance using stepwise logistic regression, only stroke subtype (OR: 30.2, 95% Cl: 5.3-171.4; p < 0.001) and KDR+/CD34(+) on admission (OR: 0.188, 95% Cl: 0.04-0.86; p = 0.031) were independently associated with 6-month outcome. Conclusions: The number of circulating EPCs is significantly lower in patients with large-vessel disease than in those with small-vessel disease. Fewer number of EPCs on admission is an independent risk factor for poor 6-month outcome in patients with AIS. (C) 2013 Elsevier B.V. All rights reserved.