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Burden of carotid atherosclerosis in patients with stroke: relationships with circulating endothelial progenitor cells and hypertension

Journal of Human Hypertension volume 21, pages 445–451 (2007)Cite this article

Abstract

Recent studies suggest that reductions in circulating endothelial progenitor cells (EPCs) may contribute to the development of atherosclerosis. However, whether reduced circulating EPCs contribute to cerebrovascular disease remains undefined. We tested the hypothesis that reduced circulating EPCs was associated with an increased burden of carotid atherosclerosis. The level of circulating CD34+/KDR+ EPCs and the extent of carotid atherosclerosis were determined in 30 patients with a history of atherothrombotic ischaemic stroke and 30 age- and sex-matched controls (mean age: 63±2 years; 63% men). Stroke patients, compared with controls, had significantly higher carotid mean maximum intima-media thickness (mmIMT) (1.08±0.05 versus 0.90±0.02 mm, P=0.002), prevalence of carotid plaque (60.0 versus 23.3%, P=0.004) and a lower number of circulating CD34+/KDR+ EPCs (235.7±45.5 versus 400.4±56.8 cells/μl, P=0.027). The circulating CD34+/KDR+ EPC count correlated negatively with carotid mmIMT (r=−0.50, P<0.001), and was an independent risk factor for increased carotid mmIMT>1 mm (odds ratio (OR): 7.71; 95% confidence interval (CI): 1.62–36.74, P=0.010) and the presence of carotid plaque (OR: 7.04; 95% CI: 1.95–25.43, P=0.003). Furthermore, stroke patients with low (<25th percentile of controls) as compared to those with normal CD34+/KDR+ EPC count had a significantly greater carotid mmIMT (1.21±0.07 versus 0.93±0.05 mm, P=0.005) and a significantly higher prevalence of carotid plaque (87.5% versus 28.6%; P=0.001). Our observations suggested that reduced circulating EPC may contribute to the progression of carotid atherosclerosis. Circulating EPC count may provide a novel marker for the burden of carotid atherosclerosis.

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Acknowledgements

This study was supported by the CRCG Small Project Funding of University of Hong Kong (Project no. 200507176137).

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Authors and Affiliations

  1. Division of Cardiology, the University of Hong Kong, Hong Kong, China

    K-K Lau, Y-H Chan, K-H Yiu, C-P Lau & H-F Tse

  2. Department of Medicine, Tung Wah Hospital, Hong Kong, China

    S-W Li

  3. Department of Clinical Biochemistry Unit, Queen Mary Hosptial, Hong Kong, China,

    S Tam

  4. Division of Hematology, Department of Medicine, the University of Hong Kong, Hong Kong, China

    Y-L Kwong

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  1. K-K Lau
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Correspondence to H-F Tse.

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Lau, KK., Chan, YH., Yiu, KH. et al. Burden of carotid atherosclerosis in patients with stroke: relationships with circulating endothelial progenitor cells and hypertension. J Hum Hypertens 21, 445–451 (2007). https://doi.org/10.1038/sj.jhh.1002178

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