Date of Graduation

Summer 8-9-2014

Degree Type

Capstone Project

Degree Name

Master of Science in Physician Assistant Studies

First Advisor

AJ Sommers

Second Advisor

Saje-Davis Reisen

Abstract

Background: Despite advances in treatment and risk factor management, coronary artery disease (CAD) remains the largest cause of mortality worldwide. Much has been made of the role of endothelial dysfunction in CAD, but tools to measure and augment its progression are lacking. Recent cellular biomarkers have been found to be involved in endothelial dysfunction and the presence of CAD. As the role of these biomarkers becomes more defined, can the measurement of endothelial progenitor cells now predict the risk of experiencing future cardiovascular events?

Methods: Exhaustive search of available medical literature was performed on the databases CINAHL, Web of Science, and Medline-OVID. These were searched using the keywords “cardiovascular events,” “endothelial cells,” and “risk assessment”. All included studies were assessed for quality using the GRADE scale.

Results: Three observational trials met inclusion requirements. One of these studies evaluated the correlation between endothelial progenitor cells (EPCs) and cardiovascular (CV) risk along with endothelial function This study was able to establish a significant correlation between the number of EPCs and their functional ability and endothelial dysfunction in patients with cardiovascular disease. The other two studies utilized a prospective approach and measured EPC numbers at baseline and then followed the sample to record the number of CV events. The first of these two studies was able to demonstrate that reduced numbers of EPC independently predicts atherosclerotic disease progression, while the second showed that EPC levels can predict the occurrence of CV events and aide in risk stratification of people with increased CV risk.

Conclusion: Endothelial progenitor cells have been proven to have a role in endothelial dysfunction, cardiovascular disease progression, and now risk assessment. While many factors play into the overall mechanism in which EPC levels affect cardiovascular risk and endothelial repair, monitoring blood levels of EPCs has become a feasible biomarker that can be added to further stratify ones CV risk profile.

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