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BACKGROUND: Current protocols for detection of circulating fibrocytes (CFs) in peripheral blood described in various pulmonary and nonpulmonary disorders involve complex and time consuming, non standardized techniques. OBJECTIVE: Testing a method to rapidly detect and quantify CFs using whole blood lysis fl ow cytometry-based assay in patients with idiopathic pulmonary fi brosis (IPF) and healthy controls. METHODS: One milliliter of venous blood sample in ethylenediaminetetraacetic acid (EDTA) from 33 IPF patients and 35 healthy control subjects was collected. Using whole blood lysis method peripheral blood leukocytes were labeled with monoclonal antibodies for cell surface (CD34 and CD45) and intracellular markers (collagen-1) for fl ow cytometric analysis. CFs were defi ned as CD45+ cells coexpressing collagen-I and CD34 molecules. RESULTS: In 29 (87.8%) IPF patients and 10 (28.5%) control subjects, a well-defi ned highly granular CD45+ cell population was detected in dot plots generated by side scatter properties of CD45+ cells. These CD45+ cells were identifi ed as CFs on the basis of coexpression of collagen-I and CD34; none of the other cell types in the peripheral blood were labeled with these monoclonal antibodies. In IPF patients the percentage of CFs was signifi cantly higher compared to healthy controls (median (range): 1.37% (0.52-5.65) and 1.04% (0.1-1.84), respectively; P = 0.03). CONCLUSIONS: Whole blood lysis method combined with fl uorescence-activated cell sorting (FACS) allows detecting a well-defi ned homogeneous population of CFs. This method is simple, reproducible, and provides an accurate and rapid estimation of CFs. [ABSTRACT FROM AUTHOR]

Background: Limited longitudinal data are available on attainment of guideline-recommended treatment targets among ambulatory patients at high risk for cardiovascular events., Methods: The Vascular Protection registry and the Guidelines Oriented Approach to Lipid Lowering registry recruited 8056 ambulatory patients at high risk for, or with established cardiovascular disease; follow-up was not protocol-mandated. We stratified the study population according to the availability of 6-month follow-up data into 2 groups, and compared their clinical characteristics, medication profile, and attainment of contemporaneous guideline-recommended blood pressure (BP) and lipid targets both at enrollment and at 6-month follow-up., Results: Of the 8056 patients, only 5371 (66.7%) patients had 6-month follow-up, who had significant increases in the use of statins and antihypertensive medications at 6 months compared with at enrollment (all P < 0.001). Compared with at time of enrollment, more patients attained the BP target (45.3% vs 42.3%), low-density lipoprotein cholesterol (LDL-C) target (62.8% vs 45.8%), and both targets (29.7% vs 21.6%) at 6-month follow-up (all P < 0.001). In multivariable analysis, independent predictors of attainment of BP target included history of coronary artery disease and heart failure (all P ≤ 0.001). On the other hand, advanced age, diabetes, coronary artery disease, previous coronary revascularization, and use of statin therapy were independently associated with achievement of LDL-C target (all P < 0.005)., Conclusions: Most (> 50%) patients without 6-month follow-up did not attain guideline-recommended BP and LDL-C targets at enrollment. Although BP and lipid control improved at 6 months among patients with follow-up, most still failed to achieve optimal BP and lipid targets. Effective ongoing quality improvement measures and follow-up are warranted., (Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)