The effect of statins on circulating endothelial progenitor cells in humans: a systematic review.
Numerous clinical trials have demonstrated early reductions in cardiovascular events occurring independently of the lipid-lowering effects of statins. These pleiotropic effects have been attributed to antiinflammatory properties, to atherosclerotic plaque stabilization, and more recently to mobilization of endothelial progenitor cells (EPCs). Our aim was to evaluate the evidence supporting statin-induced EPC mobilization in humans. We, therefore, performed a computerized literature search and systematic review of randomized trials to determine the effect of statin therapy and statin dosing on circulating EPC numbers. Our literature search identified 10 studies including 479 patients which met inclusion criteria with publication dates ranging from 2005 to 2011. Seven studies compared statin to nonstatin regimens whereas 3 studied low versus high-dose statin therapy. Reported increases in EPC number ranged from 25.8% to 223.5% with a median reported increase of 70.2% when compared to nonstatin regimens with 7 of 10 studies reporting significant increases. Considerable heterogeneity exists in regard to patient population, statin regimens, and the definition of an EPC within the identified studies. In conclusion, randomized studies in humans suggest that statin therapy mobilizes EPCs into the circulation. Larger randomized studies using uniform definitions are needed to definitively establish this effect.
*Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; †Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada; ‡Institute for Clinical Evaluative Sciences, University of Ottawa, Ottawa, Ontario, Canada; and §Division of Cardiology, Libin Cardiovascular Institute of Alberta, University of Calgary.
Benjamin
B
Hibbert
Trevor
T
Simard
F Daniel
FD
Ramirez
Ali
A
Pourdjabbar
Joshua E
JE
Raizman
Ronnen
R
Maze
Kumanan R
KR
Wilson
Steven
S
Hawken
Edward R
ER
OʼBrien
D000818:Animals; D004305:Dose-Response Relationship, Drug; D042783:Endothelial Cells / Q000166:cytology*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D016032:Randomized Controlled Trials as Topic; D013234:Stem Cells / Q000187:drug effects* / Q000378:metabolism
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors