title: Effects of preoperative short term use of atorvastatin on endothelial progenitor cells after coronary surgery: a randomized, controlled trial.
abstract: OBJECTIVE
  We investigated the effects of short-term use of atorvastatin on CD34+/VEGF-R2+/CD133+/CD45- endothelial progenitor cell (EPC) count after on-pump coronary artery bypass surgery (CABG).
  
  
  METHODS
  Between Feb-2010 and May-2010, we randomly assigned, in a placebo-controlled, double-blind study, 60 consecutive patients who underwent isolated, first-time CABG to receive either 14-day atorvastatin (40 mg/day) or placebo preoperatively. Urgent CABG and recent myocardial infarction were excluded. EPCs were quantified (cells/μl) by flow cytometric phenotyping obtained from venous blood samples collected preoperatively (T(1)), 6-hours (T(2)), and on the 5th day postoperatively (T(3)). Levels of markers of inflammation and serum cardiac troponin I were also measured preoperatively and daily until day-5 after surgery.
  
  
  RESULTS
  There were no differences in baseline risk factors including cholesterol profiles, and EuroSCORES between the groups. The composite primary end-point, favored statin group with higher amount of circulating, early EPC count (cells/μl) at all time points compared with placebo (T(1), 2.30±0.02 versus 1.58±0.03, p<0.001; T(2), 5.00±0.06 versus 2.19±0.06, p<0.001; T(3), 3.03±0.08 versus 1.78±0.02, p<0.001). Postoperative hsCRP rise were inversely correlated with EPC count, and were significantly lower in the statin group (T(1), 0.8 ± 0.1 versus 2.2±1.5, p<0.001; T(2), 72.9±3.2 versus 96.0±3.6, p<0.001; T(3), 4.3±1.2 versus 11.4±4.1, p<0.001). Furthermore, the incidence of postoperative atrial fibrillation was significantly lower in the statin group compared to placebo (3.3% versus 23%, p=0.02).
  
  
  CONCLUSIONS
  Short-term atorvastatin use increases circulating early EPCs both pre- and post-operatively and is associated with better preservation of sinus rhythm and reduced hsCRP levels. (ClinicalTrials.gov number, NCT01096875).
authors.affiliation: Department of Cardiovascular Surgery, Heart Center, Ankara University School of Medicine, Dikimevi Ankara, 06340, Turkey.
authors.forename: Çağdaş
authors.initials: Ç
authors.lastname: Baran
authors.forename: Serkan
authors.initials: S
authors.lastname: Durdu
authors.forename: Klara
authors.initials: K
authors.lastname: Dalva
authors.forename: Çagın
authors.initials: Ç
authors.lastname: Zaim
authors.forename: Arın
authors.initials: A
authors.lastname: Dogan
authors.forename: Gokhan
authors.initials: G
authors.lastname: Ocakoglu
authors.forename: Günhan
authors.initials: G
authors.lastname: Gürman
authors.forename: Önder
authors.initials: Ö
authors.lastname: Arslan
authors.forename: Ahmet Rüçhan
authors.initials: AR
authors.lastname: Akar
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000494:pharmacology / Q000627:therapeutic use*; D000069059:Atorvastatin; D002097:C-Reactive Protein / Q000378:metabolism; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000097:blood / Q000628:therapy*; D004727:Endothelium / Q000473:pathology; D005260:Female; D006538:Heptanoic Acids / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D011758:Pyrroles / Q000494:pharmacology / Q000627:therapeutic use*; D033581:Stem Cell Transplantation; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood
chemical_list: D000893:Anti-Inflammatory Agents; D006538:Heptanoic Acids; D008055:Lipids; D011758:Pyrroles; D019210:Troponin I; D002097:C-Reactive Protein; D000069059:Atorvastatin
references.citation: J Am Coll Cardiol. 2003 Dec 17;42(12):2073-80
references.pmid: 14680729
references.citation: Science. 1997 Feb 14;275(5302):964-7
references.pmid: 9020076
references.citation: J Immunoassay Immunochem. 2006;27(1):77-88
references.pmid: 16450870
references.citation: Nat Med. 2003 Jun;9(6):702-12
references.pmid: 12778169
references.citation: Eur J Cardiothorac Surg. 2006 Apr;29(4):496-500
references.pmid: 16504531
references.citation: Cytotherapy. 2010;12(1):79-87
references.pmid: 19929452
references.citation: Circulation. 2005 Jun 7;111(22):2981-7
references.pmid: 15927972
references.citation: Atherosclerosis. 2007 Jun;192(2):413-20
references.pmid: 16837000
references.citation: J Am Coll Cardiol. 2007 Feb 20;49(7):741-52
references.pmid: 17306702
references.citation: Eur Heart J. 2009 Apr;30(8):890-9
references.pmid: 19299431
references.citation: Int J Cardiol. 2008 Nov 28;130(3):457-62
references.pmid: 18667247
references.citation: Circulation. 2010 Sep 14;122(11 Suppl):S66-73
references.pmid: 20837928
references.citation: Arterioscler Thromb Vasc Biol. 2003 Jul 1;23(7):1185-9
references.pmid: 12714439
references.citation: Ann Thorac Surg. 2007 Feb;83(2):598-605
references.pmid: 17257994
references.citation: J Cardiovasc Pharmacol. 2010 Jan;55(1):30-8
references.pmid: 19834333
references.citation: N Engl J Med. 2003 Feb 13;348(7):593-600
references.pmid: 12584367
references.citation: J Thorac Cardiovasc Surg. 2008 Dec;136(6):1541-8
references.pmid: 19114204
references.citation: Nat Med. 2000 Sep;6(9):1004-10
references.pmid: 10973320
references.citation: J Vasc Surg. 2006 Oct;44(4):732-9
references.pmid: 16926085
references.citation: N Engl J Med. 2005 Sep 8;353(10):999-1007
references.pmid: 16148285
references.citation: Circulation. 2001 Jun 19;103(24):2885-90
references.pmid: 11413075
references.citation: Circulation. 2004 Aug 10;110(6):674-8
references.pmid: 15277322
references.citation: Cytometry A. 2009 Oct;75(10):848-53
references.pmid: 19739088
references.citation: Ann Thorac Surg. 2006 Dec;82(6):2315-22
references.pmid: 17126170
references.citation: Eur J Cardiothorac Surg. 2009 Oct;36(4):633-43
references.pmid: 19524451
references.citation: J Clin Invest. 2001 Aug;108(3):391-7
references.pmid: 11489932