Abstract 13860: The Impact of High Dose Atorvastatin Treatment on Endothelial Progenitor Cells, Vascular Function and Inflammatory Status in Ischemic Heart Failure
Purpose: We investigated the pleiotropic effects of different doses of atorvastatin treatment, on endothelial function, circulating endothelial progenitor cells (EPCs) number, arterial stiffness and inflammatory indices in patients with ischemic heart failure (HF).
Methods: We studied the effect of 4 weeks administration of atorvastatin in 23 patients with ischemic HF. The study was carried out on two separate arms, one with atorvastatin 40mg/d and one with atorvastatin 10mg/d (randomized, double-blind, cross-over design). Endothelial function was evaluated by flow-mediated dilation (FMD) of the brachial artery and arterial reflected waves were evaluated with augmentation index (AIx). Serum levels of intracellular adhesion molecule-1 (ICAM-1) and b-type natriuretic peptide (BNP) were measured by ELISA. The number of circulating CD34(+)/CD133(+)/KDR(+) EPCs were evaluated by flow cytometry.
Results: At baseline there was no significant difference in FMD, AIx, BNP, ICAM-1 and EPC number between the groups of 40mg/d or 10mg/d of atorvastatin (p=NS for all). Treatment with atorvastatin 40mg/d significantly improved FMD (6.05±2.45 % vs. 3.16±2.98 %, p=0.001) and AIx (23.45±8.90% vs. 26.32±8.52% , p=0.04) compared to baseline measurements. Treatment with atorvastatin 10mg/d had no significant impact in FMD (p=0.08) and AIx (p=0.41) compared to baseline measurements. Similarly, treatment with atorvastatin 40mg/d significantly improved EPC number [362 (209-456)cells/μL vs. 175 (143-232)cells/μL, p=0.002) and ICAM-1 levels [303(236-318)ng/ml vs. 227(189-329)ng/ml, p<0.001], compared to baseline measurements, while treatment with atorvastatin 10mg/d favorably affect EPC number [201 (151-309)cell/μL vs. 201 (151-309)cell/μL, p=0.01) but not ICAM-1 levels (p=0.60). Neither high or low atorvastatin dose has an impact in BNP levels (p=NS for both)
Conclusions: Short term high dose atorvastatin treatment, compared to low dose treatment, has a greater beneficial impact on vascular function and on the number of circulating EPCs with a parallel reduction in the circulating levels of adhesion molecules in ischemic HF patients. These findings highlighted the different pleiotropic potential of treatment with different statin doses in HF.
- © 2013 by American Heart Association, Inc.