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EPC boost may underlie post-AMI statin benefits
20 November 2008
Results from a small, exploratory study show that intensive statin treatment following acute myocardial infarction (AMI) increases the concentration of circulating endothelial progenitor cells (EPCs), but does not appear to significantly improve left ventricular function.
Intensive therapy with statins is known to reduce the risk for major cardiac events in individuals with acute coronary syndromes such as AMI.
“This could be related to the ability of statins to increase levels of EPCs, which were demonstrated to be favorably associated with a better prognosis and post-infarction left ventricular remodeling in patients with ischemic heart disease,” suggest Antonio Leone and fellow investigators from the Catholic University of the Sacred Heart in Rome, Italy.
To test this, they recruited 40 AMI (ST-segment elevation) patients, half of whom were randomly assigned to take “intensive” atorvastatin 80 mg/day immediately after admission and half “standard” atorvastatin 20 mg/day from their day of discharge.
Patients’ left ventricular function was assessed by echocardiography and blood levels of EPCs by flow cytometry at admission, discharge, and after 4 months.
As reported in the International Journal of Cardiology, the researchers found that EPC count at 4 months was considerably higher for patients in the intensive compared with the standard statin treatment group, at an average of 7.59 versus 3.04 cells/ml.
However, no significant differences in left ventricular function were observed between groups.
Leone et al suggest this may be due to the small size and relatively short follow-up of the study.
They conclude: “Our study suggests that further trials… should be carried out on a background of intensive statin treatment in order to optimize the potential beneficial effects of these innovative approaches.”
Dimitris Tousoulis (Athens University Medical School, Greece) and fellow authors of an accompanying editorial commented: “This interesting study raises important questions regarding both the role of EPCs in acute ischemic heart disease and the effects of statin treatment on EPCs and other prognostic markers in patients with acute coronary syndromes.”
