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European Heart Journal Advance Access published online on December 24, 2008
European Heart Journal, doi:10.1093/eurheartj/ehn566
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Expression of stromal-cell-derived factor-1 on circulating platelets is increased in patients with acute coronary syndrome and correlates with the number of CD34+ progenitor cells

Konstantinos Stellos1,*, Boris Bigalke1, Harald Langer1, Tobias Geisler1, Annika Schad1, Andreas Kögel3, Florian Pfaff1, Dimitrios Stakos2, Peter Seizer1, Iris Müller1, Patrick Htun1, Stephan Lindemann1 and Meinrad Gawaz1,*

1 Medizinische Klinik III, Kardiologie und Kreislauferkrankungen, Eberhard Karls-Universität Tübingen, Otfried-Müller Str. 10, 72076 Tübingen, Germany
2 University Cardiology Clinic, Democritus University of Thrace, Alexandroupolis, Greece
3 Institut Schreier, Statistical Support, Tübingen, Germany

Received 2 January 2008; revised 4 November 2008; accepted 27 November 2008.

* Corresponding author. Tel: +49 70712983688, Fax: +49 7071295040, Email: konstantinos.stellos{at}med.uni-tuebingen.de (K.S.) or meinrad.gawaz{at}med.uni-tuebingen.de (M.G.)

Aims: Previous experimental studies have suggested that platelet stromal-cell-derived factor-1 (SDF-1) regulates mobilization and recruitment of haematopoietic progenitor cells supporting revascularization in mice. However, there are no clinical data available regarding platelet-bound SDF-1 in patients with acute coronary syndrome (ACS). The objective of this study was to evaluate the platelet-surface expression of SDF-1 in patients with ACS.

Methods and results: Patients with ACS (n = 418) showed a significantly enhanced SDF-1 expression on admission compared with those with stable angina pectoris (SAP, n = 486) [SAP (mean fluorescence intensity (MFI)±SD): 13.48 ± 5.27; ACS: 18.45 ± 12.85; P < 0.001) independent of cardiovascular risk factors and medication. Enhanced platelet-bound SDF-1 expression was found in patients with reduced left ventricular ejection fraction (LVEF <55%) in comparison to patients with normal LVEF (P = 0.005). Platelet-bound SDF-1 expression positively correlated with the degree of platelet activation [CD62P: r = 0.325; glycoprotein VI (GPVI): r = 0.277; PAC-1: r = 0.501; P < 0.001 for all] and showed a significant, but slight association with plasma levels of SDF-1 (r = 0.084; P = 0.045). In a subgroup of patients with coronary artery disease, platelet-bound SDF-1, but not other platelet activation markers, significantly correlated with the number of circulating CD34+ progenitor cells (r = 0.252; P = 0.002) or CD34+/CD133+ endothelial progenitor cells (r = 0.352; P = 0.008).

Conclusion: Platelet-bound SDF-1 may play an important role in peripheral homing of circulating progenitor cells thus in tissue regeneration.

Key Words: SDF-1 • Platelets • Progenitor cells • Acute coronary syndrome


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