title: The effect of angiotensin-2 receptor blocker valsartan on circulating level of endothelial progenitor cells in diabetic patients with asymptomatic coronary artery disease.
abstract: BACKGROUND
  Decreased circulating endothelial progenitor cells (EPCs) are considered as strong and robust biomarkers for the prediction of cardiovascular outcomes in diabetic populations. The perspectives for modulating EPCs levels in T2DM with known coronary artery disease (CAD) with different drugs, affected mechanisms of improving mobilization of EPCs from tissue, are not still understood.
  
  
  OBJECTIVE
  To evaluate an effect of angiotensin-2 receptor blocker valsartan on circulating level of EPCs in diabetic patients with asymptomatic CAD.
  
  
  METHODS
  The study population was structured retrospectively after determining the CAD by contrast-enhanced spiral computed tomography angiography in 126 asymptomatic subjects. All subjects were distributed into two cohorts depending on daily doses of valsartan given. Low (80-160 mg daily orally) and high doses (240-320 mg daily orally) of valsartan were used and they were adjusted depending on achieving BP level less than 140/80 mmHg.
  
  
  RESULTS
  The change from baseline in CD34(+) subset cells (frequencies and absolute values) was not significantly different between treatment cohorts. We found a significant increase of circulating level of CD14(+)CD309(+) cells in two patient cohorts. But more prominent change of CD14(+)CD309(+) cells was verified in subjects who were given valsartan in high daily doses when compared with persons who were included into cohort with low daily doses of the drug (1.96% versus 2.59%, respectively; P<0.05). Therefore, both frequencies and absolute values in CD14(+)CD309(+)Tie(2+) were increased significantly in patients who were treated with high doses of valsartan only.
  
  
  CONCLUSIONS
  We found positive influence of angiotensin-2 receptor blocker valsartan in escalation doses on bone marrow-derived EPCs phenotyped as CD14(+)CD309(+) and CD14(+)CD309(+)Tie(2+) in T2DM patients with known asymptomatic CAD.
authors.affiliation: Internal Medicine Department, State Medical University, Zaporozhye, Ukraine. Electronic address: dr_berezin@mail.ru.
authors.forename: Alexander E
authors.initials: AE
authors.lastname: Berezin
authors.affiliation: Clinical Pharmacology Department, State Medical University, Zaporozhye, Ukraine.
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Kremzer
authors.affiliation: Pathology Department, State Medical University, Zaporozhye, Ukraine.
authors.forename: Yulia V
authors.initials: YV
authors.lastname: Martovitskaya
authors.affiliation: Clinical Pharmacology Department, State Medical University, Zaporozhye, Ukraine.
authors.forename: Tatyana A
authors.initials: TA
authors.lastname: Samura
mesh_terms: D057911:Angiotensin Receptor Antagonists / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000188:drug therapy* / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D066026:Endothelial Progenitor Cells / Q000187:drug effects* / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D000068756:Valsartan / Q000627:therapeutic use*
chemical_list: D057911:Angiotensin Receptor Antagonists; D015415:Biomarkers; D000068756:Valsartan
keywords: Angiotensin-2 receptor blocker; Asymptomatic coronary artery disease; Circulating mononuclear cells; Type two diabetes mellitus