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KMID : 0368120080380080411
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Korean Circulation Journal
2008 Volume.38 No. 8 p.411 ~ p.418
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Effect of Early Statin Therapy on Circulating Endothelial Progenitor Cells During the Acute Phase in Patients With Acute Myocardial Infarction
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Choi Jun-Ho
Park Eun-Mi
Rhee Sang-Jae
Yoo Nam-Jin
Jeong Jin-Won
Lee Eun-Mi
Kim Seung-Hwan
Oh Seok-Kyu
Kim Nam-Ho
Yun Kyeong-Ho
Shin Ik-Sang
Lee An Saeng
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Abstract
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Background and Objectives: The mobilization of circulating endothelial progenitor cells (EPCs) might represent a useful strategy for the clinical therapy of ischemic heart disease. We examined the effect of early statin therapy before reperfusion therapy on the circulating EPCs during the acute phase in patients with acute myocardial infarction (AMI).
Subjects and Methods: A total of 84 consecutive AMI patients undergoing primary percutaneous coronary intervention (PCI) within 24 hours of pain onset were included in this study. We randomly divided the patients into 3 groups according to rosuvastatin therapy before PCI: the control group (n:27, 19 males and 8 females, 58±2 years of age), the rosuvastatin 10 mg group (n: 28, 21 males and 7 females, 58±3 years of age) and the 40 mg group (n: 29, 23 males and 6 females, 59±2 years of age). The circulating EPCs and high sensitivity C-reactive protein (hs-CRP) levels were analyzed on admission and at 1, 3, 5, 7 and 30 days after PCI. The circulating EPCs were measured by flow cytometry as the CD45lowCD34+VEGFR2+ cells.
Results: The circulating EPCs peaked on day 3 after PCI, whereas the increment of circulating EPCs was significantly suppressed in the rosuvastatin 10 mg and 40 mg groups compared with the control group on day 3 (control vs rosuvastatin 10 mg vs rosuvastatin 40 mg: 0.072% vs 0.067% vs 0.061%, respectively, p=0.002) and day 5 (0.068% vs 0.060% vs 0.058%, respectively, p=0.029). The level of hs-CRP markedly increased from day 1 and this peaked on day 3 after PCI. Early statin therapy significantly suppressed the elevation of hs-CRP compared with the control group on day 1 (24.36 mg/L vs 17.88 mg/L vs 13.08 mg/L, respectively, p=0.035) and on day 3 (30.15 mg/L vs 22.78 mg/L vs 17.16 mg/L, respectively, p=0.034). There was a statistically significant correlation between the circulating EPCs and the hs-CRP (r=0.349, p=0.007).
Conclusion: In the AMI patients, the early stain therapy before reperfusion therapy didn’t increase the mobilization of circulating EPCs, but it suppressed the elevation of hs-CRP. This data suggests that the mobilization of circulating EPCs may be related to systemic inflammation during the acute phase in patients with AMI.
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KEYWORD
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Progenitorcell, HydroxymethylglutarylCoAreductaseinhibitors, Myocardialinfarction, C-reactiveprotein
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