Improvement in endothelial progenitor cells from peripheral blood by ramipril therapy in patients with stable coronary artery disease.
OBJECTIVE
The aim of this study is to investigate whether angiotensin-converting enzyme inhibitor (ACEI) therapy with ramipril could augment circulating endothelial progenitor cells (EPCs) with enhanced functional activity in patients with stable coronary artery diseases.


RESULTS
20 patients with angiographically documented stable coronary artery disease (CAD) were prospectively treated with 5 mg of ramipril per day for 4 weeks. Before and weekly after the initiation of ramipril therapy, EPCs were isolated from peripheral blood and counted. Ramipril treatment of patients with stable CAD was associated with an approximately 1.5-fold increase in the number of circulating EPCs by 1 week after initiation of treatment; this was followed by sustained increased levels to approximately 2.5-fold throughout the 4-week study period. In addition, ramipril treatmen was associated with increases in the functional activity of EPCs, as assessed by their proliferation, migration, adhesion and in vitro vasculogenesis capacity.


CONCLUSIONS
The results of the present study define a novel mechanism of action of ACEI treatment in patients with stable CAD: the augmentation of circulating EPCs with enhanced functional activity. Given the well-established role of EPCs of participating in repair after ischemic injury, stimulation of EPCs by ACEI may contribute to the clinical benefit of ACEI therapy in patients with CAD.
Min
Tao Qian
TQ
Department of Cardiovascular Diseases, the First Affiliated Hospital, Medical School of Zhejiang University, Zhejiang Province, People's Republic of China.
Zhu
Chen Jun
CJ
Xiang
Wang Xing
WX
Hui
Zhu Jun
ZJ
Peng
Shang Yun
SY
D000368:Aged; D001794:Blood Pressure / Q000187:drug effects; D002448:Cell Adhesion / Q000187:drug effects; D002465:Cell Movement / Q000187:drug effects; D049109:Cell Proliferation / Q000187:drug effects; D048430:Cell Shape / Q000187:drug effects / Q000235:genetics; D002478:Cells, Cultured; D002681:China; D002908:Chronic Disease; D003327:Coronary Disease / Q000188:drug therapy* / Q000503:physiopathology*; D004334:Drug Administration Schedule; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000473:pathology; D005260:Female; D015870:Gene Expression; D006801:Humans; D008297:Male; D059630:Mesenchymal Stem Cells / Q000187:drug effects* / Q000473:pathology / Q000502:physiology*; D009569:Nitric Oxide / Q000378:metabolism; D010601:Pharmacology, Clinical / Q000379:methods; D017257:Ramipril / Q000494:pharmacology / Q000627:therapeutic use*; D013997:Time Factors; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000737:chemistry / Q000187:drug effects / Q000235:genetics
D009569:Nitric Oxide; D040301:Vascular Endothelial Growth Factor Receptor-2; D017257:Ramipril