Predictive value of the decrease in circulating dendritic cell precursors in stable coronary artery disease
Résumé
Dendritic cells (DC) are present in atherosclerotic lesions leading to vascular inflammation. The number of vascular DC increases during atherosclerosis. Recently, we showed that circulating DCP are reduced in acute coronary syndromes through vascular recruitment. In our present study, we investigated whether DCP might be reduced in stable coronary artery disease (CAD) too. The numbers of circulating myeloid (mDCP), plasmacytoid (pDCP), and total DCP (tDCP) were flow cytometrically investigated in 290 patients with suspected stable CAD. The coronary angiogram was used to evaluate for each patient a CAD Score: 1. excluded CAD (n=57), 2. early CAD (n=63), 3. moderate CAD (n=85), and 4. advanced CAD (n=85). Compared to controls, patients with advanced stable CAD had lower HDL cholesterol (p = 0.03) and higher creatinine (p = 0.003). In advanced CAD a significant decrease of circulating mDCP, pDCP, and tDCP was shown (each P < 0.001). A significant inverse correlation was observed between the CAD Score and mDCP, pDCP, or tDCP (each P < 0.001). Patients who required a percutaneous coronary intervention or coronary artery bypass grafting had less circulating mDCP, pDCP, and tDCP than controls (each p < 0.001). Multiple stepwise logistic regression analysis proved mDCP, pDCP, and tDCP as independent predictors of a CAD. In conclusion, we show that patients with stable CAD have significantly lower numbers of circulating DCP than healthy individuals. Their decrease seems to be an independent predictor of the presence and consecutive therapeutical procedure in stable CAD.
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