European Heart Journal Advance Access originally published online on April 5, 2007
European Heart Journal 2007 28(15):1805-1813; doi:10.1093/eurheartj/ehm065
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Early haemoglobin-independent increase of plasma erythropoietin levels in patients with acute myocardial infarction
1 Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, P.le Golgi 2, 27100 Pavia, Italy
2 Biotechnology Laboratory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
3 Organ Transplantation Laboratory, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
4 Laboratory of Clinical Epidemiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
5 Intensive Coronary Care Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
6 Pediatric Department, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
7 Department of Applied and Behavioural Sanitary Science, University of Pavia, Pavia, Italy
Received 21 July 2006; revised 26 February 2007; accepted 8 March 2007; online publish-ahead-of-print 5 April 2007.
* Corresponding author. Tel: +39 0382 501598; fax: +39 0382 503159. E-mail address: m.ferrario{at}smatteo.pv.it
See page 1785 for the editorial comment on this article (doi:10.1093/eurheartj/ehm260)
Aims: We studied plasma erythropoietin (EPO) levels and their relation with CD34+VEGFR-2+ (mature and progenitor endothelial cells) and CD34+ CD133+VEGFR-2+, or CD34+ CD117+VEGFR-2+ (early/immature endothelial progenitors) cells in patients with acute myocardial infarction (AMI).
Methods and results: Fifty AMI patients undergoing percutaneous coronary intervention (PCI) within 6 h of symptom onset were enrolled. EPO, measured by ELISA, and cell subsets, by cytofluorimetric analysis, were evaluated before PCI, 24 h and 7 days afterwards. Forty-five healthy subjects (CTRLs) were studied. Plasma EPO levels were higher in AMI patients at admission, 24 h, and 7 days (P = 0.04, P = 0.0001, P = 0.001, respectively) than in CTRLs. No correlation was evidenced between EPO and haemoglobin (Hb) or haematocrit at admission or 24 h after AMI. Differently, both Hb and haematocrit inversely correlated with EPO at day 7 (P = 0.0016, P = 0.029, respectively). Plasma EPO levels correlated with CD34+CD133+VEGFR-2+ cells at day 7 (P = 0.03).
Conclusion: AMI patients have increased plasma EPO levels until day 7. In the early phase, plasma EPO levels are Hb-independent; at day 7, an Hb-modulated increase of EPO correlates with the percentage of CD34+CD133+VEGFR-2+ cells.
Key Words: Acute myocardial infarction • Erythropoietin • Vascular endothelial growth factor • Endothelial progenitors
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