Role of Stromal Cell-Derived Factor-1.ALPHA., Level and Value of Circulating Interleukin-10 and Endothelial Progenitor Cells in Patients With Acute Myocardial Infarction Undergoing Primary Coronary Angioplasty

The relationships among the circulating levels of endothelial progenitor cells (EPC), stromal cell-derived factor (SDF)-1alpha, interleukin (IL)-10 and outcome were examined in patients with ST-segment elevation acute myocardial infarction (ST-se AMI) undergoing primary coronary angioplasty.Circulating levels of IL-10, SDF-1alpha, and EPCs [defined by staining markers: CD31/CD34 (E(1)) and KDR/CD34 (E(2))] were examined by ELISA and flow cytometry, respectively. The IL-10 level was higher, whereas the circulating level of EPCs (E(1-2)) was lower (all P0.05) in AMI patients than in normal subjects. Additionally, the SDF-1alpha level was significantly and independently predictive of an increased level of circulating EPCs (E(1-2)) (P0.0001). Furthermore, patients with a high SDF-1alpha level (1,500 pg/ml) had lower left ventricular performance, higher Killip score (defined asor=3), and increased 30-day mortality than those with low SDF-1alpha level (or=1,500 pg/ml) (all P0.007). Moreover, high circulating levels of E(2) and IL-10 were the most significant independent predictors of increased 30-day major adverse clinical outcome (MACO) (defined as advanced Killip scoreor=3 or 30-day mortality) (P0.01).The serum SDF-1alpha level is independently predictive of an increased level of circulating EPCs (E(1-2)). E(2) and IL-10 are major independent predictors of 30-day MACO in ST-se AMI patients undergoing primary coronary angioplasty.