Endothelial and circulating progenitor cells as prognostic biomarkers of stroke: A systematic review and meta-analysis

IF 3.7 3区医学 Q1 HEMATOLOGY

Thrombosis research Pub Date : 2024-11-16 DOI:10.1016/j.thromres.2024.109224

Juan Francisco García Granado , Francisco Javier Rodríguez Esparragón , Jesús María González Martín , Sara E. Cazorla Rivero , Ayoze Nauzet González Hernández

{"title":"Endothelial and circulating progenitor cells as prognostic biomarkers of stroke: A systematic review and meta-analysis","authors":"Juan Francisco García Granado , Francisco Javier Rodríguez Esparragón , Jesús María González Martín , Sara E. Cazorla Rivero , Ayoze Nauzet González Hernández","doi":"10.1016/j.thromres.2024.109224","DOIUrl":null,"url":null,"abstract":"<div><h3>Purpose</h3><div>Endothelial progenitor cells (EPCs) are biomarkers of neurovascular repair in cerebral vascular disease (CVD). Low quantification of EPCs and/or their dysfunction has been associated with stroke severity and post-stroke functionality. This systematic review (SR) and meta-analysis aimed to analyze whether EPC quantification contributes to stroke severity and functional prognosis.</div></div><div><h3>Methods</h3><div>Articles were selected from the PubMed, ScienceDirect, and Ovid MEDLINE databases, according to the guidelines of the PRISMA 2020 [<span><span>1</span></span>] statement. Detailed observational studies of samples from subjects with a clinical diagnosis of CVD (ischemic stroke-IS, hemorrhagic stroke-HS, or transient ischemic attack-TIA) aged >45 years during 2003–2023 were included. Evaluation of study quality was based on the Critical Appraisal Skills Programme checklist(Santamaría, 2017 [<span><span>2</span></span>]).</div></div><div><h3>Results</h3><div>We included 22 articles in our SR. Patients with IS and good functional outcomes had higher EPC levels during the first week of admission than those with worse functional outcomes. Higher EPC levels were associated with reduced infarct growth, improved NIHSS scores at 48 h (OR 0.8; 95 % CI: 0.72–0.90; <em>p</em> < 0.0002) 7 (<em>r</em> = −0.607; <em>p</em> < 0.0001), and 90 days (<em>r</em> = −0.570; p < 0.0001), with a negative correlation between EPC levels and NIHSS score (overall pooled r = −0,32, 95 % CI: −0.39-0.24), and good functional outcomes with better mRS scores at 24 h, 3, 6, and 12 months (overall pooled SMD 4.51, CI 95 %: 0.70–0.83). Lower EPC quantification and worse functional outcomes during admission were predictors of IS recurrence. Higher EPC levels were associated with better functional outcomes and lower bleeding volumes in patients with HS and were protective markers for the progression high-risk TIA.</div></div><div><h3>Conclusion</h3><div>EPCs seems to be predictive biomarkers of better clinical outcomes in patients with CVD, exhibiting lower severity (NIHSS) and better functional prognosis (mRS).</div></div>","PeriodicalId":23064,"journal":{"name":"Thrombosis research","volume":"245 ","pages":"Article 109224"},"PeriodicalIF":3.7000,"publicationDate":"2024-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Thrombosis research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0049384824003566","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"HEMATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Purpose

Endothelial progenitor cells (EPCs) are biomarkers of neurovascular repair in cerebral vascular disease (CVD). Low quantification of EPCs and/or their dysfunction has been associated with stroke severity and post-stroke functionality. This systematic review (SR) and meta-analysis aimed to analyze whether EPC quantification contributes to stroke severity and functional prognosis.

Methods

Articles were selected from the PubMed, ScienceDirect, and Ovid MEDLINE databases, according to the guidelines of the PRISMA 2020 [1] statement. Detailed observational studies of samples from subjects with a clinical diagnosis of CVD (ischemic stroke-IS, hemorrhagic stroke-HS, or transient ischemic attack-TIA) aged >45 years during 2003–2023 were included. Evaluation of study quality was based on the Critical Appraisal Skills Programme checklist(Santamaría, 2017 [2]).

Results

We included 22 articles in our SR. Patients with IS and good functional outcomes had higher EPC levels during the first week of admission than those with worse functional outcomes. Higher EPC levels were associated with reduced infarct growth, improved NIHSS scores at 48 h (OR 0.8; 95 % CI: 0.72–0.90; p < 0.0002) 7 (r = −0.607; p < 0.0001), and 90 days (r = −0.570; p < 0.0001), with a negative correlation between EPC levels and NIHSS score (overall pooled r = −0,32, 95 % CI: −0.39-0.24), and good functional outcomes with better mRS scores at 24 h, 3, 6, and 12 months (overall pooled SMD 4.51, CI 95 %: 0.70–0.83). Lower EPC quantification and worse functional outcomes during admission were predictors of IS recurrence. Higher EPC levels were associated with better functional outcomes and lower bleeding volumes in patients with HS and were protective markers for the progression high-risk TIA.

Conclusion

EPCs seems to be predictive biomarkers of better clinical outcomes in patients with CVD, exhibiting lower severity (NIHSS) and better functional prognosis (mRS).

查看原文本刊更多论文

作为中风预后生物标志物的内皮细胞和循环祖细胞：系统综述和荟萃分析。

目的：内皮祖细胞（EPCs）是脑血管疾病（CVD）中神经血管修复的生物标志物。EPCs的低定量和/或功能障碍与中风的严重程度和中风后的功能有关。本系统综述（SR）和荟萃分析旨在分析EPC定量是否与中风严重程度和功能预后有关：根据 PRISMA 2020 [1] 声明的指导原则，从 PubMed、ScienceDirect 和 Ovid MEDLINE 数据库中筛选文章。研究纳入了 2003-2023 年间年龄大于 45 岁、临床诊断为心血管疾病（缺血性卒中-IS、出血性卒中-HS 或短暂性脑缺血发作-TIA）的受试者样本的详细观察性研究。研究质量的评估基于批判性评价技能计划检查表（Santamaría，2017 [2]）：我们在SR中纳入了22篇文章。与功能预后较差的患者相比，功能预后良好的IS患者在入院第一周的EPC水平较高。较高的 EPC 水平与减少梗死生长、改善 48 小时后的 NIHSS 评分有关（OR 0.8；95 % CI：0.72-0.90；P 结论：EPCs 似乎是一种预测性的生物标志物：EPC似乎是心血管疾病患者获得更好临床预后的预测性生物标志物，可显示较低的严重程度（NIHSS）和较好的功能预后（mRS）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Thrombosis research 医学-外周血管病

CiteScore

14.60

自引率

4.00%

发文量

364

审稿时长

31 days

期刊介绍： Thrombosis Research is an international journal dedicated to the swift dissemination of new information on thrombosis, hemostasis, and vascular biology, aimed at advancing both science and clinical care. The journal publishes peer-reviewed original research, reviews, editorials, opinions, and critiques, covering both basic and clinical studies. Priority is given to research that promises novel approaches in the diagnosis, therapy, prognosis, and prevention of thrombotic and hemorrhagic diseases.