Decreased levels of circulating CD34(+) cells are associated with coronary heart disease in Japanese patients with type 2 diabetes

AIMS/INTRODUCTION: Circulating progenitor cells, including CD34 positive (CD34(+)) cells, play a key role in neovascularisation and the maintenance of vascular endothelial function. Several lines of evidence show an association between decreased levels of circulating CD34(+) cells and cardiovascular disease. However, the contribution of circulating CD34(+) cells to the occurrence of cardiovascular events in diabetic patients remains unclear. MATERIALS AND METHODS: In the present study with a median follow up of 4.6 years, we analyzed the level of circulating CD34(+) cells in 192 patients with type 2 diabetes. The outcome variables were coronary heart disease (CHD) events (cardiovascular death, unstable angina, myocardial infarction, percutaneous coronary intervention or coronary artery bypass grafting) and cerebrovascular disease events (cerebral infarction, cerebral hemorrhage or transient ischemic attack). RESULTS: Decreased levels of circulating CD34(+) cells were associated with a significantly higher incidence of CHD based on Kaplan–Meier analysis (P = 0.0052). After adjusting for age, sex, dyslipidemia, hypertension, glycated hemoglobin, history of cardiovascular disease, body mass index, and statin and renin angiotensin system inhibitors use, decreased levels of CD34(+) cells were significantly associated with the incidence of CHD events (hazard ratio of low tertile 2.61, 95% confidence interval 1.22–5.96; P = 0.013, reference; high tertile). CONCLUSIONS: Decreased levels of circulating CD34(+) cells might predict CHD events in patients with diabetes, and this could be useful for identifying patients with diabetes at high risk of cardiovascular events.