Key result
Atorvastatin 80 mg increases progenitor cells and reduces VEGF only in diabetic CVD patients.
Why the study?
Cardiovascular disease causes morbidity and mortality especially with diabetes, possibly due to endothelial damage reflected by circulating progenitor cells and angiogenesis markers, and the effects of atorvastatin on these markers in atherosclerotic CVD with or without diabetes were unclear.
Does atorvastatin 80 mg per day improve circulating progenitor cells and indices of angiogenesis in patients with atherosclerotic cardiovascular disease with or without diabetes mellitus?
Does atorvastatin 80 mg per day improve circulating progenitor cells and indices of angiogenesis in patients with atherosclerotic cardiovascular disease with or without diabetes mellitus?
p-value: p=<0.001
High-dose atorvastatin increases circulating progenitor cells and modulates angiogenesis markers in patients with diabetes and cardiovascular disease, highlighting potential pleiotropic vascular benefits.
Jaumdally RJ, Goon PKY, Varma C, Blann AD, Lip GYH (City Hospital, Birmingham, United Kingdom). Effects of atorvastatin on circulating CD34+/CD133+/CD45− progenitor cells and indices of angiogenesis (vascular endothelial growth factor and the angiopoietins 1 and 2) in atherosclerotic vascular disease and diabetes mellitus. J Intern Med 2010; 267: 385–393. Background. Cardiovascular disease (CVD) remains a major cause of morbidity and mortality, especially in the presence of diabetes, possibly because of endothelial damage. Increased circulating progenitor cells (CPCs) and increased plasma markers of angiogenesis [vascular endothelial growth factor (VEGF) and the angiopoietins (Ang‐1 and ‐2)] may be evidence of this damage. Treatment with hydroxy‐methyl‐glutaryl (HMG‐CoA) reductase inhibitors (‘statins’) improves outcomes in patients with vascular disease, including diabetic patients. We hypothesized that 80 mg per day atorvastatin influences CPC counts of VEGF and the angiopoietins in patients with atherosclerotic CVD with or without diabetes mellitus. Methods. Cardiovascular disease patients with diabetes mellitus (Group A, n = 14) and nondiabetic patients with CVD only (Group B, n = 10) took atorvastatin 80 mg per day for a period of 8–10 weeks. CPCs (CD34+/CD133+/CD45−) were defined by flow cytometry, plasma levels VEGF and Ang‐1 and Ang‐2 by ELISA). Results. Circulating progenitor cell counts increased (P < 0.001) in Group A compared with a nonsignificant change in Group B (P = 0.37). VEGF levels fell significantly in Group A (P = 0.04) but no significant change was seen in Group B (P = 0.16). Whilst Ang‐1 remained unchanged (P = 0.41), Ang‐2 levels increased markedly in both groups (P < 0.05). These effects were independent of LDL and total cholesterol changes but were associated with HDL changes Conclusion. High‐dose atorvastatin increased circulating CPCs, reduced VEGF and increased Ang‐2 in patients with diabetes and CVD, providing another possible pathophysiological mechanism for the beneficial effects of statins in CVD.
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Jaumdally et al. (2009) studied Atherosclerotic vascular disease with or without diabetes mellitus (n=24). Atorvastatin vs. Nondiabetic patients with CVD only was evaluated on Circulating progenitor cell (CPC) counts (p=<0.001). Atorvastatin 80 mg/day significantly increased circulating progenitor cells (P<0.001) and reduced VEGF (P=0.04) in patients with diabetes and CVD, but not in those with CVD alone.
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