Spadaccio C, Pollari F, Md AC, Alfano G, Genovese J, Covino E, Chello M
Atorvastatin increases the number of endothelial progenitor cells after cardiac surgery: a randomized control study. [JOURNAL ARTICLE]
J Cardiovasc Pharmacol 2009 Oct 9.
Endothelial Progenitor Cells(EPCs) are a subtype of haematopoietic stem cells which contribute to the repair of injured endothelium. Treatment with atorvastatin has been shown to increase EPC count in patients with coronary artery disease, therefore we investigated whether atorvastatin augments the number of EPCs after cardiopulmonary bypass(CPB) surgery.Randomized, double-blind, placebo-controlled two way cross-over trial in 50 patients undergoing elective coronary surgery. Patients received either 3 weeks treatment with atorvastatin, or placebo. EPCs were quantitated by flow cytometric phenotyping on blood samples.Levels of interleukin IL-6, IL-8,TNFalpha,SDF-1alpha,GCSF and VEGF were determined at recruitment, preoperatively, post-CPB,6,12,and 24 hours postoperatively. The atorvastatin group showed a significantly higher amount of EPCs both pre-and post-operatively compared with the placebo, with a >4-fold increase compared with the baseline values. CPB induced an increase in all cytokines, but the levels of proinflammatory cytokines were significantly lower in the atorvastatin group(p<0.05). Statin did not affect levels of SDF-1alpha GCSF and VEGF. However, no correlation was found between plasma levels of any cytokine and number of EPCs, with the exception of SDF-1alpha. Pre-treatment with atorvastatin significantly increases the amount of EPCs after CPB, by a mechanism independent of plasma levels of cytokines and cholesterol.
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