title: 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.
authors.affiliation: Nanjing University Medical School, Department of Cardiology, Affiliated Drum Tower Hospital, Nanjing 210008, China.
authors.forename: Jia-Yin
authors.initials: JY
authors.lastname: Sun
authors.forename: Lin
authors.initials: L
authors.lastname: Zhai
authors.forename: Qiao-Ling
authors.initials: QL
authors.lastname: Li
authors.forename: Jia-Xin
authors.initials: JX
authors.lastname: Ye
authors.forename: Li-Na
authors.initials: LN
authors.lastname: Kang
authors.forename: Jun
authors.initials: J
authors.lastname: Xie
authors.forename: Biao
authors.initials: B
authors.lastname: Xu
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000032:analysis; D054377:Chemokine CXCL12 / Q000097:blood; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications*; D042783:Endothelial Cells / Q000166:cytology / Q000187:drug effects*; D005260:Female; D005500:Follow-Up Studies; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D020913:Perindopril / Q000627:therapeutic use*; D011379:Prognosis; D011446:Prospective Studies; D013234:Stem Cells / Q000166:cytology / Q000187:drug effects*; D042461:Vascular Endothelial Growth Factor A / Q000097:blood
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D054377:Chemokine CXCL12; D042461:Vascular Endothelial Growth Factor A; D002097:C-Reactive Protein; D020913:Perindopril