Role of stromal cell-derived factor-1α, level and value of circulating interleukin-10 and endothelial progenitor cells in patients with acute myocardial infarction undergoing primary coronary angioplasty

Background: The relationships among the circulating levels of endothelial progenitor cells (EPC), stromal cell-derived factor (SDF)-1α, interleukin (IL)-10 and outcome were examined in patients with ST-segment elevation acute myocardial infarction (ST-se AMI) undergoing primary coronary angioplasty. Methods and Results: Circulating levels of IL-10, SDF-1α, and EPCs [defined by staining markers: CD31/CD34 (E1) and KDR/CD34 (E2)] were examined by ELISA and flow cytometry, respectively. The IL-10 level was higher, whereas the circulating level of EPCs (E1-2) was lower (all P<0.05) in AMI patients than in normal subjects. Additionally, the SDF-1α level was significantly and independently predictive of an increased level of circulating EPCs (E1-2) (P<0.0001). Furthermore, patients with a high SDF-1α level (>1,500 pg/ml) had lower left ventricular performance, higher Killip score (defined as ≥3), and increased 30-day mortality than those with low SDF-1α level (≤1,500 pg/ml) (all P<0.007). Moreover, high circulating levels of E2 and IL-10 were the most significant independent predictors of increased 30-day major adverse clinical outcome (MACO) (defined as advanced Killip score ≥3 or 30-day mortality) (P<0.01). Conclusions: The serum SDF-1α level is independently predictive of an increased level of circulating EPCs (E1-2). E2 and IL-10 are major independent predictors of 30-day MACO in ST-se AMI patients undergoing primary coronary angioplasty.