Association between EPCs count and rate of coronary revascularization in asymptomatic type 2 diabetic patients

Coronary arterial disease (CAD) is common in diabetic patients, and endothelial progenitor cells (EPCs) are considered a surrogate marker for CAD, but controversies regarding this issue still remain. We investigated the potential clinical role of EPCs during coronary screening in asymptomatic type 2 diabetic patients screened with cardiovascular magnetic resonance (CMR). A total of 100 asymptomatic type 2 diabetic subjects (51 men and 49 women) were enrolled. Clinical and laboratory parameters, including EPCs (CD34(+)/CD133(+)/VEGFR-2(+)) count, were evaluated and CMR was performed. A total of 51 patients [silent myocardial infarction (n = 3), inducible ischemia (n = 11), suspected CAD (n = 37)] had abnormal finding on CMR. Of the 20 patients who later underwent invasive coronary angiography, 8 were treated with revascularization. Fifty-one subjects with abnormal finding on CMR were divided into two groups [subjects with revascularization (group I, n = 8) vs. without revascularization (group II, n = 43)]. Group I had a significantly increased EPCs level than group II (833 vs. 415, P = 0.027). Multivariate logistic regression analysis revealed that an increased EPCs level (OR = 1.003, P = 0.024) and a high body-mass index (OR = 1.907, P = 0.028) were independently correlated with revascularization. In our study, increased EPCs count is associated with performing revascularization in asymptomatic type 2 diabetic patients, and that increased EPCs count can provide clinically important information while performing intervention.