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Increased levels of circulating endothelial progenitor cells in patients with ischaemic stroke treated with statins during acute phase
Author(s) -
Sobrino T.,
Blanco M.,
PérezMato M.,
RodríguezYáñez M.,
Castillo J.
Publication year - 2012
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/j.1468-1331.2012.03770.x
Subject(s) - medicine , atorvastatin , statin , progenitor cell , stroke (engine) , endothelial progenitor cell , gastroenterology , stem cell , mechanical engineering , genetics , engineering , biology
Background and purpose Endothelial progenitor cells ( EPC s) have been suggested to be a therapeutic option in ischaemic stroke. Our aim was to study whether statin treatment during acute phase could increase circulating EPC s after acute ischaemic stroke. Methods We studied 48 patients with a first‐ever non‐lacunar ischaemic stroke (<12 h from stroke onset). Sixteen patients received statin treatment (20 mg atorvastatin/day) during the first 4 days. We defined the EPC increment during the first week as the difference in the number of early outgrowth colony‐forming unit‐endothelial cell ( CFU ‐ EC ) between day 7 and at admission (previous to atorvastatin treatment). Serum levels of vascular endothelial growth factor and active matrix metalloproteinase 9 (determined by ELISA ), and nitric oxide metabolites ( NO x) (determined by high‐performance liquid chromatography) were measured at admission, 24 and 72 h, and day 7. Results Colony‐forming unit‐endothelial cells were similar at baseline between patients treated ( n = 16) and non‐treated ( n = 32) with statins (10.1 ± 3.9 vs. 7.9 ± 6.9 CFU ‐ EC , P = 0.223). However, patients treated with statins showed a higher EPC increment (24.0 ± 17.3 vs. 6.0 ± 17.8 CFU ‐ EC , P = 0.002) during the first week. An EPC increment ≥ 4 CFU ‐ EC predicted with the highest sensitivity (88%) and specificity (92%) the probability of good outcome (area under the curve 0.903, P < 0.0001). Statin treatment ( OR , 13.1; CI 95%, 2.2–76.9, P = 0.004) was independently associated with an EPC increment ≥ 4 CFU ‐ EC after adjustment for confounder factors, but this association was lost when adjusting for NO x levels. Conclusions Statin treatment for 4 days may increase circulating EPC levels, probably by NO ‐related mechanisms.