title: Atorvastatin increases the number of endothelial progenitor cells after cardiac surgery: a randomized control study.
abstract: Endothelial progenitor cells (EPCs) are a subtype of hematopoietic 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. We conducted a randomized double-blind, placebo-controlled, 2-way crossover trial in 50 patients undergoing elective coronary surgery. Patients received either 3-week treatment with atorvastatin or placebo. EPCs were quantitated by flow cytometric phenotyping on blood samples. Levels of interleukin, IL-6 and IL-8; tumor necrosis factor alpha; SDF-1alpha; granulocyte colony-stimulating factor; and vascular endothelial growth factor were determined at recruitment, preoperatively, post-CPB, and 6, 12, and 24 hours postoperatively. The atorvastatin group showed a significantly higher amount of EPCs both pre- and postoperatively 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, granulocyte colony-stimulating factor, and vascular endothelial growth factor. However, no correlation was found between plasma levels of any cytokine and number of EPCs, with the exception of SDF-1alpha. Pretreatment with atorvastatin significantly increases the amount of EPCs after CPB, by a mechanism independent of plasma levels of cytokines and cholesterol.
authors.affiliation: Department of Cardiovascular Sciences, University Campus Bio-Medico of Rome, Rome, Italy.
authors.forename: Cristiano
authors.initials: C
authors.lastname: Spadaccio
authors.forename: Francesco
authors.initials: F
authors.lastname: Pollari
authors.forename: Adele
authors.initials: A
authors.lastname: Casacalenda
authors.forename: Gennaro
authors.initials: G
authors.lastname: Alfano
authors.forename: Jorge
authors.initials: J
authors.lastname: Genovese
authors.forename: Elvio
authors.initials: E
authors.lastname: Covino
authors.forename: Massimo
authors.initials: M
authors.lastname: Chello
mesh_terms: D000368:Aged; D000924:Anticholesteremic Agents / Q000494:pharmacology*; D000069059:Atorvastatin; D002315:Cardiopulmonary Bypass; D002784:Cholesterol / Q000097:blood; D018592:Cross-Over Studies; D016207:Cytokines / Q000187:drug effects / Q000378:metabolism; D004311:Double-Blind Method; D042783:Endothelial Cells / Q000187:drug effects / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry; D006412:Hematopoietic Stem Cells / Q000187:drug effects* / Q000378:metabolism; D006538:Heptanoic Acids / Q000494:pharmacology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011758:Pyrroles / Q000494:pharmacology*; D013997:Time Factors
chemical_list: D000924:Anticholesteremic Agents; D016207:Cytokines; D006538:Heptanoic Acids; D011758:Pyrroles; D002784:Cholesterol; D000069059:Atorvastatin