Department of Cardiology, University Hospital Aachen, RWTH Aachen University, Aachen, Germany.
Institute for Molecular Medicine, University of South Denmark, Odense, Denmark.
PLoS One. 2022 May 19;17(5):e0267433. doi: 10.1371/journal.pone.0267433. eCollection 2022.
By low-density lipoprotein (LDL) reduction, statins play an important role in cardiovascular risk modification. Incompletely understood pleiotropic statin effects include vasoprotection that might originate from mobilisation and differentiation of vascular progenitor cells. Data on the potentially differential impact of statin treatment intensity on circulating progenitor cells in patients undergoing percutaneous coronary intervention (PCI) are scarce. This study examines the potential association of different permanent statin treatment regimens on circulating progenitor cells in patients with coronary syndrome.
In a monocentric prospective all-comers study, 105 consecutive cases scheduled for coronary angiography due to either (A) non-invasive proof of ischemia and chronic coronary syndrome (CCS) or (B) troponin-positive acute coronary syndrome (ACS) were included. According to the 2018 American College of Cardiology Guidelines on Blood Cholesterol, patients were clustered depending on their respective permanent statin treatment regimen in either a high- to moderate-intensity statin treatment (HIST) or a low-intensity statin treatment (LIST) group. Baseline characteristics including LDL levels were comparable. From blood drawn at the time of PCI, peripheral blood mononuclear cells were isolated, cultivated and counted and, by density gradient centrifugation, levels of circulating progenitor cells were determined using fluorescence-activated cell sorting (FACS) analysis. In ACS patients both absolute and relative numbers of circulating early-outgrowth endothelial progenitor cells (EPCs) concurrently were significantly lower in the HIST group as compared to the LIST group. This effect was more pronounced in ACS patients than in CCS patients. Both in ACS and CCS patients, HIST caused a significant reduction of the number of circulating SMPCs.
In patients undergoing PCI, a dose intensity-dependent and LDL level-independent pro-differentiating vasoprotective pleiotropic capacity of statins for EPC and SMPC is demonstrated.
通过降低低密度脂蛋白（LDL）水平，他汀类药物在心血管风险修正中发挥重要作用。他汀类药物不完全了解的多效性作用包括血管保护，这种作用可能源于血管祖细胞的动员和分化。关于他汀类药物治疗强度对经皮冠状动脉介入治疗（PCI）患者循环祖细胞的潜在差异影响的数据很少。本研究旨在探讨不同的他汀类药物治疗方案对冠心病综合征患者循环祖细胞的潜在影响。
在一项单中心前瞻性所有患者研究中，连续纳入了 105 例因以下原因接受冠状动脉造影的患者：（A）非侵入性缺血证据和慢性冠状动脉综合征（CCS）或（B）肌钙蛋白阳性急性冠状动脉综合征（ACS）。根据 2018 年美国心脏病学会关于血液胆固醇的指南，根据患者的永久性他汀类药物治疗方案将患者分组，分为高强度至中度强度他汀类药物治疗（HIST）或低强度他汀类药物治疗（LIST）组。基线特征包括 LDL 水平。在 PCI 时抽取血液，分离、培养和计数外周血单核细胞，并通过密度梯度离心，使用荧光激活细胞分选（FACS）分析确定循环祖细胞的水平。在 ACS 患者中，与 LIST 组相比，HIST 组的循环早期生长内皮祖细胞（EPC）的绝对和相对数量均显著降低。这种效应在 ACS 患者中比在 CCS 患者中更为明显。在 ACS 和 CCS 患者中，HIST 均导致循环 SMPC 数量显著减少。
在接受 PCI 的患者中，他汀类药物具有剂量强度依赖性和 LDL 水平独立性的促分化血管保护多效性，可增强 EPC 和 SMPC。
