Cardiovascular event rates in patients with ST-elevation myocardial infarction were lower with early increases in mobilization of Oct4 ^highNanog^high stem cells into the peripheral circulation during a 4-year follow-up

Background Long-term clinical implications of embryonic stem cell markers such as Oct4 and Nanog have not been investigated in ST-elevation myocardial infarction (STEMI) patients. The aim of this study was to investigate the effects of early peripheral mobilization of stem cells with Oct4 and Nanog gene expression on major adverse cardiovascular events (MACEs) in patients with STEMI during a 4-year follow-up. Methods Peripheral blood mononuclear cells (PBMCs) were isolated on days 0, 1 and 7 from patients with STEMI (n = 40) and healthy controls (n = 20). The numbers of CD34 +, CD117 +, CD133 + and c-met + stem cells were measured by flow-cytometry. Oct4 and Nanog gene expressions were analyzed by real-time PCR. MACEs such as non-fatal MI, death, stroke, target lesion and revascularization were observed. Results MACEs were significantly lower in patients with Oct4 gene expression ≥ 1.13 and Nanog gene expression ≥ 1.20 at admission. The numbers of CD34 +, CD117 +, CD133 + and c-met + cells within 7 days after STEMI did not show significant differences in patients with or without MACE. Level of anti-inflammatory marker such as IL-10 was significantly higher within 7 days following STEMI in patients without MACE. Inflammatory and angiogenic markers such as CRP, IL-6, SCF, SDF-1α, and VEGF did not show significant differences in patients with or without MACE. Conclusion mRNA levels of pluripotent embryonic stem cell markers such as Oct4 and Nanog were significantly higher in STEMI patients without MACEs during a 4-year follow-up. Baseline Oct4 and Nanog gene expression levels could be used as predictors of MACE in STEMI patients.