High-Dose Atorvastatin Reloading Before Percutaneous Coronary Intervention Increased Circulating Endothelial Progenitor Cells and Reduced Inflammatory Cytokine Expression During the Perioperative Period

Abstract

Our results suggested that high-dose atorvastatin application before PCI triggered early EPC circulation. Furthermore, postoperative inflammatory cytokine sICAM-1 as well as hCRP serum levels were reduced, while postinterventional myocardial injury marker TnI elevations were inversely correlated with statin reloadings.

Atorvastatin, Losartan and Captopril Lead to Upregulation of TGF-β, and Downregulation of IL-6 in Coronary Artery Disease and Hypertension

“…It has been demonstrated that IL-6, IL-8 and tumor necrosis factor-alpha (TNF-α) are the main pro-inflammatory cytokines that are produced by several cells such as macrophages and denderitic cell [2]. The cytokines induce immune cells activation and recruitment and also are the main inducers of arthrosclerosis [3]. TNF-α is the main inducer of infectious shock and can induce hypotension which is the main cause of coma and death in the infected patients [4].…”

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)

“…22 More recently, Ye et al found increased number of EPCs in patients on long-term statin therapy receiving an atorvastatin reload before PCI, but these investigators did not perform an analysis of EPC functional status and did not analyze differences in EPC numbers at time of randomization. 23 However, to the best of our knowledge, no previous investigations have analyzed at the same time effects on EPC number and function with a few hours pretreatment with high-dose statin in patients on long-term therapy and with a randomized controlled study design. Specifically in our study, we replicated the treatment design of the ARMYDA RECAPTURE, 14 whereby we demonstrated that a reload with high-dose atorvastatin improves periprocedural outcome in patients on long-term statin therapy who underwent PCI.…”

Endothelial progenitor cells: Exploring the pleiotropic effects of statins

“…The authors found no beneficial effect in an improvement of LV function[98]. Furthermore statin reloading in patients on moderate statin therapy undergoing percutaneous coronary intervention has been shown to increase EPC count[99,100] this correlates with the beneficial effect of statin reloading of high dose statin in patients on chronic therapy[80] mentioned above.…”

“…However, the RISK pathway has been shown the down regulated with chronic statin therapy[158] and has been shown to become reactivated by statin re-loading[159]. The latter may account for the increase in EPC count in patients on chronic statin therapy reloaded with statin therapy[80,99,100]. …”