title: Effect of High-Dose Atorvastatin Reload on the Release of Endothelial Progenitor Cells in Patients on Long-Term Statin Treatment Who Underwent Percutaneous Coronary Intervention (from the ARMYDA-EPC Study).
abstract: Endothelial progenitor cells (EPCs) may concur to endogenous vascular repair. Previous studies have reported that statin treatment increases EPC levels. We investigated whether this occurs in patients on long-term statin treatment who underwent percutaneous coronary interventions (PCIs). In a phase A study, 53 patients (atorvastatin reload [AR] 80 mg 12 hours before + 40 mg 2 hours before PCI, n = 27; placebo [P], n = 26) were evaluated for EPC mobilization as CD45dim/CD34+/CD133+/KDR+ cell number by flow cytometry. Assays were run at randomization (12 hours before PCI, R), immediately before PCI (T0) at 8 (T8) and 24 hours (T24). In phase B study, 50 patients (AR, n = 25; P, n = 25) were evaluated for early colony formation by Hill colony forming unit (CFU) assay, with sampling at randomization and 24 hours later. In phase A, EPCs levels were similar at randomization between 2 arms (0.23% [0.14 to 0.54] of total events in AR vs 0.22% [0.04 to 0.37] in P group; p = 0.33). At PCI, EPC levels were higher in AR arm (0.42% [0.06 to 0.30] vs 0.19% [0.06 to 030]; p = 0.009). Higher EPC levels in AR group were also found at 8 and 24 hours. In phase B, EPC CFUs/well numbers at randomization were similar in the 2 arms (8 [6 to 12] in AR vs 12 [6 to 20] in P group, p = 0.109). EPC CFU/well at 24 hours became significantly higher in AR arm (17 [10 to 23] vs 5 [2 to 13], p = 0.002). In conclusion, high-dose AR before PCI in patients on long-term statin therapy promptly increases EPCs mobilization, which are capable of early colony formation and may contribute to cardioprotection.
authors.affiliation: Unit of Cardiovascular Sciences, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy. Electronic address: e.ricottini@unicampus.it.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Ricottini
authors.affiliation: Institute of Cardiology and Center of Excellence on Aging, "G. D'Annunzio" University, Chieti, Italy.
authors.forename: Rosalinda
authors.initials: R
authors.lastname: Madonna
authors.affiliation: Unit of Cardiovascular Sciences, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Grieco
authors.affiliation: Unit of Oncology, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Alice
authors.initials: A
authors.lastname: Zoccoli
authors.affiliation: Unit of Clinical Pathology and Microbiology, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Stampachiacchiere
authors.affiliation: Unit of Cardiovascular Sciences, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Patti
authors.affiliation: Unit of Oncology, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Tonini
authors.affiliation: Institute of Cardiology and Center of Excellence on Aging, "G. D'Annunzio" University, Chieti, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: De Caterina
authors.affiliation: Unit of Cardiovascular Sciences, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.
authors.forename: Germano
authors.initials: G
authors.lastname: Di Sciascio
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D000368:Aged; D000069059:Atorvastatin / Q000008:administration & dosage*; D002452:Cell Count; D004305:Dose-Response Relationship, Drug; D004562:Electrocardiography; D066026:Endothelial Progenitor Cells / Q000166:cytology*; D005260:Female; D005434:Flow Cytometry; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage; D008297:Male; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000069059:Atorvastatin