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Blood, 15 January 2005, Vol. 105, No. 2, pp. 526-532. Prepublished online as a Blood First Edition Paper on September 16, 2004; DOI 10.1182/blood-2004-03-1106. This Article Full Text (PDF) All Versions of this Article: 2004-03-1106v1 105/2/526    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Lee, K. W Articles by Blann, A. D Search for Related Content PubMed PubMed Citation Articles by Lee, K. W Articles by Blann, A. D Social Bookmarking                   What's this?  Previous Article  |  Next Article  Submitted March 25, 2004 Accepted September 2, 2004 Circulating endothelial cells, Von Willebrand Factor, interleukin-6 and prognosis in patients with acute coronary syndromes Kaeng W Lee, Gregory Y Lip*, Muzahir Tayebjee, William Foster, and Andrew D Blann Haemostasis Thrombosis and Vascular Biology Unit, City Hospital, Birmingham, UK * Corresponding author; email: g.y.h.lip{at}bham.ac.uk. Background: Markers of inflammation (e.g. interleukin-6[IL-6]), and endothelial perturbation (von Willebrand factor[vWf], circulating endothelial cells[CECs]) are altered in acute coronary syndromes (ACS). We hypothesised that CECs and IL-6 levels during the first 48hrs of ACS would predict 30day and 1 year major cardiovascular endpoints (MACE). Methods: 156 patients with ACS were included. Blood was drawn on admission (baseline) and 48hrs later for plasma vWf, IL-6 (both ELISA) and CECs (immunomagnetic separation). CEC phenotyping was performed by indirect immunoperoxidase staining. Results: At 30days, 48 patients had 1 MACE, predicted by baseline and 48hr CECs and IL-6 levels, 48hr vWf levels, and by the 'admission to 48hr change'() in CECs, vWf and IL-6 (all p 0.002). On multivariate analysis, 48hr CECs (p<0.001) were the strongest predictor of MACE, followed by IL-6 (p=0.01) and vWf (p=0.048); 48hr CECs were the only predictor of death (p=0.007). At 1 year, 65 patients had1 MACE, predicted by 48hr CECs and IL-6 levels (p<0.001); age (p=0.046) and 48hr CECs (p<0.001) were the only predictors of death. CECs stained 93% positive for eNOS, but were <1% positive for CD34, CD36 and CD45, and <3% for CD31. Conclusions: Like raised vWf, abnormal CECs and IL-6 levels during the first 48hrs of ACS were strongly associated with 30day MACE. CECs at 48hrs were the only independent predictor of both death and MACE at 30days and 1 year, indicating the crucial role of endothelial/vascular damage in ACS pathophysiology. CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: H.-H. Wang, C.-I Kung, Y.-Y. Tseng, Y.-C. Lin, C.-H. Chen, C.-H. Tsai, and H.-I Yeh Activation of endothelial cells to pathological status by down-regulation of connexin43 Cardiovasc Res, May 17, 2008; (2008) cvn112v2. [Abstract] [Full Text] [PDF] A. O. Spiel, J. C. Gilbert, and B. Jilma Von Willebrand Factor in Cardiovascular Disease: Focus on Acute Coronary Syndromes Circulation, March 18, 2008; 117(11): 1449 - 1459. [Abstract] [Full Text] [PDF] C. J. Boos, B. Balakrishnan, S. Jessani, A. D. Blann, and G. Y. H. 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