Circulating Progenitor Cells and Cognitive Impairment in Men and Women with Coronary Artery Disease

Article type: Research Article

Authors: Moazzami, Kasra^{a; b} | Wittbrodt, Matthew T.^c | Lima, Bruno B.^{a; b} | Kim, Jeong Hwan^{a; b} | Hammadah, Muhammad^{a; b} | Ko, Yi-An^d | Obideen, Malik^{a; b} | Abdelhadi, Naser^{a; b} | Kaseer, Belal^{a; b} | Gafeer, M. Mazen^{a; b} | Nye, Jonathon A.^e | Shah, Amit J.^{a; b; f} | Ward, Laura^d | Raggi, Paolo^{a; g} | Waller, Edmund K.^h | Bremner, J. Douglas^{c; e; f} | Quyyumi, Arshed A.^{b; 1} | Vaccarino, Viola^{a; b; 1; *}

Affiliations: [a] Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA | [b] Department of Medicine, Emory Clinical Cardiovascular Research Institute, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA | [c] Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA | [d] Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA | [e] Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA | [f] Atlanta VA Medical Center, Decatur, GA, USA | [g] Mazankowski Alberta Heart Institute, University of Alberta, Alberta, Canada | [h] Department of Hematology and Oncology, Winship Cancer Institute, Atlanta, GA, USA

Correspondence: [*] Correspondence to: Viola Vaccarino, MD, PhD, Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA. E-mail: viola.vaccarino@emory.edu.

Note: [1] These authors contributed equally to this work.

Abstract: Background:Circulating progenitor cells (CPC) have been associated with memory function and cognitive impairment in healthy adults. However, it is unclear whether such associations also exist in patients with coronary artery disease (CAD). Objective:To assess the association between CPCs and memory performance among individuals with CAD. Methods:We assessed cognitive function in 509 patients with CAD using the verbal and visual Memory subtests of the Wechsler memory scale-IV and the Trail Making Test parts A and B. CPCs were enumerated with flow cytometry as CD45med/CD34+ blood mononuclear cells, those co-expressing other epitopes representing populations enriched for hematopoietic and endothelial progenitors. Results:After adjusting for demographic and cardiovascular risk factors, lower number of endothelial progenitor cell counts were independently associated with lower visual and verbal memory scores (p for all < 0.05). There was a significant interaction in the magnitude of this association with race (p < 0.01), such that the association of verbal memory scores with endothelial progenitor subsets was present in Black but not in non-Black participants. No associations were present with the hematopoietic progenitor-enriched cells or with the Trail Making Tests. Conclusion:Lower numbers of circulating endothelial progenitor cells are associated with cognitive impairment in patients with CAD, suggesting a protective effect of repair/regeneration processes in the maintenance of cognitive status. Impairment of verbal memory function was more strongly associated with lower CPC counts in Black compared to non-Black participants with CAD. Whether strategies designed to improve regenerative capacity will improve cognition needs further study.

Keywords: Circulating progenitor cells, cognitive impairment, coronary artery disease, dementia, memory, trail making tests, Wechsler Memory Scale

DOI: 10.3233/JAD-191063

Journal: Journal of Alzheimer's Disease, vol. 74, no. 2, pp. 659-668, 2020