Hibbert Benjamin, Simard Trevor, Ramirez F Daniel, Pourdjabbar Ali, Raizman Joshua E, Maze Ronnen, Wilson Kumanan R, Hawken Steven, OʼBrien Edward R
*Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada; †Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada; ‡Institute for Clinical Evaluative Sciences, University of Ottawa, Ottawa, Ontario, Canada; and §Division of Cardiology, Libin Cardiovascular Institute of Alberta, University of Calgary.
J Cardiovasc Pharmacol. 2013 Nov;62(5):491-6. doi: 10.1097/FJC.0b013e3182a4027f.
Numerous clinical trials have demonstrated early reductions in cardiovascular events occurring independently of the lipid-lowering effects of statins. These pleiotropic effects have been attributed to antiinflammatory properties, to atherosclerotic plaque stabilization, and more recently to mobilization of endothelial progenitor cells (EPCs). Our aim was to evaluate the evidence supporting statin-induced EPC mobilization in humans. We, therefore, performed a computerized literature search and systematic review of randomized trials to determine the effect of statin therapy and statin dosing on circulating EPC numbers. Our literature search identified 10 studies including 479 patients which met inclusion criteria with publication dates ranging from 2005 to 2011. Seven studies compared statin to nonstatin regimens whereas 3 studied low versus high-dose statin therapy. Reported increases in EPC number ranged from 25.8% to 223.5% with a median reported increase of 70.2% when compared to nonstatin regimens with 7 of 10 studies reporting significant increases. Considerable heterogeneity exists in regard to patient population, statin regimens, and the definition of an EPC within the identified studies. In conclusion, randomized studies in humans suggest that statin therapy mobilizes EPCs into the circulation. Larger randomized studies using uniform definitions are needed to definitively establish this effect.
众多临床试验已证明，他汀类药物可使心血管事件早期减少，且这种作用独立于其降脂效果。这些多效性作用归因于抗炎特性、动脉粥样硬化斑块稳定作用，以及最近发现的内皮祖细胞（EPC）动员作用。我们的目的是评估支持他汀类药物诱导人体EPC动员的证据。因此，我们进行了计算机文献检索并对随机试验进行系统评价，以确定他汀类药物治疗及他汀类药物剂量对循环EPC数量的影响。我们的文献检索确定了10项研究，包括479例符合纳入标准的患者，发表日期从2005年至2011年。7项研究比较了他汀类药物与非他汀类药物治疗方案，而3项研究比较了低剂量与高剂量他汀类药物治疗。与非他汀类药物治疗方案相比，报道的EPC数量增加范围为25.8%至223.5%，报告的中位数增加为70.2%，10项研究中有7项报告有显著增加。在所确定的研究中，患者人群、他汀类药物治疗方案以及EPC的定义存在相当大的异质性。总之，人体随机研究表明，他汀类药物治疗可使EPC动员进入循环。需要进行更大规模的采用统一定义的随机研究来明确证实这种作用。
