Comparison of the effects of ramipril versus telmisartan on high-sensitivity C-reactive protein and endothelial progenitor cells after acute coronary syndrome.
To compare the anti-inflammatory and endothelial progenitor cell mobilizing effects of ramipril and telmisartan in patients presenting with acute coronary syndrome (ACS), 42 patients with ACS were randomized after successful percutaneous coronary intervention to ramipril 5 mg/day (22 patients) or telmisartan 80 mg/day (20 patients). Peripheral blood samples were drawn at baseline and at 20 days to measure high-sensitivity C-reactive protein and to assess 4 populations of progenitor cells by flow cytometry, namely CD34+/KDR+, CD34+/CD133+, CD34+/CD133+/CD45-, and CD34+/KDR+/CD45- cells. High-sensitivity C-reactive protein levels, similar in the 2 groups at baseline, were significantly more decreased by telmisartan than by ramipril at follow up (p = 0.013 for time-by-drug interaction). The main effect for time was also significant (p <0.001). CD34+/KDR+ and CD34+/CD133+ cells were similar at baseline and did not change over time (p = 0.2 and p = 0.1, respectively). In contrast, for CD34+/KDR+/CD45- and CD34+/CD133+/CD45- cells, a significant increase with time was seen (p = 0.02 and p = 0.002, respectively) and no differential effect of either drug was seen. In conclusion, telmisartan shows a more potent anti-inflammatory effect than ramipril after an ACS. The 2 drugs do not show a differential effect on endothelial progenitor cell mobilization.
Porto
Italo
I
Department of Cardiovascular Medicine, Catholic University of the Sacred Heart, Rome, Italy. i.porto@doctors.org.uk
Di Vito
Luca
L
De Maria
Giovanni Luigi
GL
Dato
Ilaria
I
Tritarelli
Alessandra
A
Leone
Antonio Maria
AM
Niccoli
Giampaolo
G
Capogrossi
Maurizio C
MC
Biasucci
Luigi Marzio
LM
Crea
Filippo
F
D054058:Acute Coronary Syndrome / Q000097:blood*; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology* / Q000627:therapeutic use; D001562:Benzimidazoles / Q000494:pharmacology* / Q000627:therapeutic use; D001565:Benzoates / Q000494:pharmacology* / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000032:analysis*; D004730:Endothelium, Vascular / Q000166:cytology*; D005260:Female; D005434:Flow Cytometry; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017257:Ramipril / Q000494:pharmacology* / Q000627:therapeutic use; D013234:Stem Cells / Q000378:metabolism*; D000077333:Telmisartan
D000806:Angiotensin-Converting Enzyme Inhibitors; D001562:Benzimidazoles; D001565:Benzoates; D002097:C-Reactive Protein; D017257:Ramipril; D000077333:Telmisartan