Effects of ACE inhibition on endothelial progenitor cell mobilization and prognosis after acute myocardial infarction in type 2 diabetic patients

Abstract

OBJECTIVE:We aimed to assess the chemotactic response of endothelial progenitor cells to angiotensin-converting enzyme inhibitors in T2DM patients after acute myocardial infarction, as well as the associated prognosis.METHODS:Sixty-eight T2DM patients with acute myocardial infarction were randomized to either receive or not receive daily oral perindopril 4 mg, and 36 non-diabetic patients with acute myocardial infarction were enrolled as controls. The numbers of circulating CD45−/low+CD34+CD133+KDR+ endothelial progenitor cells, as well as the stromal cell-derived factor-α and high-sensitivity C reactive protein levels, were measured before acute percutaneous coronary intervention and on days 1, 3, 5, 7, 14, and 28 after percutaneous coronary intervention. Patients were followed up for 6 months. Chinese Clinical Trial Registry: ChiCTR-TRC-12002599.RESULTS:T2DM patients had lower circulating endothelial progenitor cell counts, decreased plasma vascular endothelial growth factor and α levels, and higher plasma high-sensitivity C reactive protein levels compared with non-diabetic controls. After receiving perindopril, the number of circulating endothelial progenitor cells increased from day 3 to 7, as did the plasma levels of vascular endothelial growth factor and stromal cell-derived factor-α, compared with the levels in T2DM controls. Plasma high-sensitivity C reactive protein levels in the treated group decreased to the same levels as those in non-diabetic controls. Furthermore, compared with T2DM controls, the perindopril-treated T2DM patients had lower cardiovascular mortality and occurrence of heart failure symptoms (p<0.05) and better left ventricle function (p<0.01).CONCLUSIONS:The use of angiotensin-converting enzyme inhibitors represents a novel approach for improving cardiovascular repair after acute myocardial infarction in T2DM patients.

Impaired Circulating Angiogenic Cells Mobilization and Metalloproteinase-9 Activity after Dynamic Exercise in Early Metabolic Syndrome

“…Some studies have demonstrated that subjects with cardiometabolic diseases present reduced baseline levels of CD34 + /VEGFR2 + cells [ 11 ] when compared with healthy controls. However, the current population with MetS is free of overt disease or pharmacological treatment, and these factors are known to alter the results [ 12 , 13 , 44 ].…”

“…Jialal et al [ 11 ] showed a reduced number of CACs along with impaired functionality in subjects with MetS, who were using antihypertensive drugs. However, some drugs, such as antihypertensives and statins, are already known to influence the number and/or functionality of CACs [ 12 , 13 ]. Thus, whether the number of CACs is already altered in drug naïve subjects with MetS is unclear.…”

Simvastatin attenuates TNF-α-induced apoptosis in endothelial progenitor cells via the upregulation of SIRT1

“…Moreover, it has been reported that a low EPC level is an independent risk factor for future cardiovascular events such as unstable angina and myocardial infarction (MI) (7,8). MI (9) and limb ischemia (10,11) themselves have been associated with an increase in circulating EPC numbers, and vascular traumas such as acute MI with ST elevation (12) and percutaneous coronary intervention (13) have been suggested to induce the rapid mobilization of EPCs.…”

Endothelial progenitor cells and vascular endothelial growth factor after endovascular interventions in patients with type 2 diabetes

“…В исследовании Lin Ling и соавт. [19] оценивали динамику циркулирующих ЭПК и факторов, стимули-рующих мобилизацию ЭПК (VEGF и хемокинстромаль-ный фактор-1 (SDF-1α)) у больных с острым инфарктом миокарда (ОИМ). В группе пациентов с СД2 отмечалось снижение мобилизации и снижение пикового повыше-ния ЭПК по сравнению с пациентами без СД2, в то время как уровни VEGF и SDF-1α плазмы крови были выше в группе пациентов с СД2.…”