Circulating precursors of endothelial cells in patients with CHD and disturbed carbohydrate metabolism

Abstract

Aim.
Circulating precursors of endothelial cells (PEC) play an important role in regeneration of damaged vascular endothelium and myocardium and neovascularization of ischemic tissues. The aim of this work was to study effect of disturbed carbohydrate metabolism (DCM) on the number of PEC in patients with different forms of CHD.
Materials and methods.
The number of PEC was determined by flow cytofluometry, insulin and C-peptide levels by IFA in 78 patients aged 40-69 (mean 55.5?0.9) years. Control groups comprised 17 subjects without CHD and DCM, 33 patients were allocated to the stable angina (SA) group (48% with DCM), 28 suffered acute coronary syndrome without segment ST elevation (ACS-ST) (39% had DCM).
Results.
The number of PEC was reduced in all CHD patients, by 23% in the SA group (p<0.05) and by 43% in the ACS-ST group (p<0.001). The number of PEC in patients of the latter group was 26% smaller than in the SA group (p<0.05). Patients with SA and DCM showed a significant decrease in PEC compared with controls (p<0.05) and tendency (insignificant) toward decrease compared with SA patients without DCM. The presence or absence of DCM in the ACS-ST group did not influence the number of PEC. The number of PEC negatively correlated with blood glucose level (r=-0.23, p=0.04) and insulin concentration in SA patients (r=-0.48, p=0.01).
Conclusion.
The number of PEC in peripheral blood of patients with CHD is reduced; the decrease is especially pronounced in patients with ACS-ST. SA is associated with the most significant decrease in circulating CD34+ cells in the presence of DCM whereas DCM has no marked effect on the number of PEC in ACS-ST patients. The higher the blood glucose level the smaller the number of circulating CD34+ cells.