Assessing the impact of cardioprotective therapies on vascular regenerative cell content in people at risk for adverse cardiovascular events
Abstract
Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of death globally and is exacerbated by cardiometabolic risk factors such as type 2 diabetes (T2D) and dyslipidemia. These conditions promote systemic inflammation and oxidative stress that drives cardiac event risk. Using high-throughput flow cytometry previously showed that T2D and obesity deplete circulating vascular regenerative (VR) progenitor cell pools, which are essential for coordinating blood vessel repair and maintaining homeostasis. Moreover, VR cell stores could be restored with empagliflozin in T2D and bariatric surgery in obesity. Herein, we hypothesized that the restoration of VR cell content is a conserved mechanism in therapies that lower cardiovascular event risk. We sought to determine (1) the impact of empagliflozin on VR cell content in individuals without T2D with cardiac risk factors, (2) the effects of icosapent ethyl (IPE) in individuals with established ASCVD and/or T2D, and (3) the relationship between renal health and VR cell content. Our findings indicate that non-diabetic individuals randomized to receive empagliflozin exhibited similar boosts in VR cell content as demonstrated in people with T2D, and that the use of IPE led to increased VR cell content and increases in early granulocyte precursor cell content. Additionally, we have demonstrated that clinical metrics (i.e. eGFR) may predict VR cell deficiencies. This thesis offers novel insights into the cardioprotective…
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Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design.
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