Effects of Preoperative Short Term Use of Atorvastatin on Endothelial Progenitor Cells after Coronary Surgery: A Randomized, Controlled Trial.
Author(s): Baran C, Durdu S, Dalva K, Zaim C, Dogan A, Ocakoglu G, Gurman G, Arslan O, Akar AR
Affiliation(s): Department of Cardiovascular Surgery, Heart Center, Ankara University School of Medicine, Dikimevi, Ankara, 06340, Turkey.
Publication date & source: 2011-11-11, Stem Cell Rev., [Epub ahead of print]
OBJECTIVES: 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/mul) 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/mul) 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).