Low-dose versus moderate-dose atorvastatin after acute myocardial infarction: 8-month effects on coronary flow reserve and angiogenic cell mobilisation.

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  • Additional Information
    • Source:
      Publisher: BMJ Pub. Group Country of Publication: England NLM ID: 9602087 Publication Model: Print Cited Medium: Internet ISSN: 1468-201X (Electronic) Linking ISSN: 13556037 NLM ISO Abbreviation: Heart Subsets: MEDLINE
    • Publication Information:
      Original Publication: London : BMJ Pub. Group, c1996-
    • Subject Terms:
      Coronary Circulation/*drug effects ; Heptanoic Acids/*administration & dosage ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/*administration & dosage ; Myocardial Infarction/*drug therapy ; Neovascularization, Physiologic/*drug effects ; Pyrroles/*administration & dosage; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antigens, CD34/blood ; Atorvastatin ; Biomarkers/blood ; Cholesterol, LDL/blood ; Cytokines/blood ; Dose-Response Relationship, Drug ; Follow-Up Studies ; Heptanoic Acids/therapeutic use ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; Inflammation Mediators/blood ; Middle Aged ; Myocardial Infarction/physiopathology ; Pyrroles/therapeutic use ; Receptors, CXCR4/blood ; Stents ; Young Adult
    • Abstract:
      Objective: To compare the effects of atorvastatin 10 mg versus 40 mg in circulating angiogenic cell mobilisations and in restoring coronary flow reserve (CFR) during the 8-month follow-up in patients with a first acute myocardial infarction (AMI).
      Design: CFR was measured using an intracoronary Doppler wire in 102 patients with AMI at baseline and at 8 months. Changes in the absolute number of circulating angiogenic cells were measured at baseline, 1 day, 5 days and at 8 months. Stented patients were randomly assigned to either low-dose atorvastatin 10 mg (ATOR10, n=52) or moderate-dose atorvastatin 40 mg (ATOR40, n=50). Setting University Hospital.
      Results: CFR increased significantly in both groups during the 8-month follow-up. The 8-month increases from baseline in CFR were significantly greater in the ATOR40 group than in the ATOR10 group (0.99+/-0.69 vs 0.55+/-0.47, p=0.017, respectively). The serial increases in the absolute number of CD34+ and CXCR4+ cells were significantly greater in the ATOR40 group, especially at 24 h after the procedure (two-way repeated-measures analysis of variance: p=0.046 and p=0.022, respectively). Decreases from baseline for interleukin 6 (-2.94+/-3.31 vs -1.52+/-2.82 pg/ml), tumour necrosis factor alpha (-1.31+/-2.96 vs -0.01+/-1.29 pg/ml), soluble intercellular adhesion molecule-1 (-71+/-95 vs 37+/-83 ng/ml) and soluble vascular cell adhesion molecule-1 (-51+/-364 vs 190+/-204 ng/ml) were significantly greater in the ATOR40 group.
      Conclusions: The recovery of microvascular integrity after acute ischaemic injury in the ATOR40 group was expedited by greater circulating angiogenic cell mobilisations such as CD34+ and CXCR4+ cells, together with greater decreases in inflammatory cytokines and low-density lipoprotein-cholesterol concentrations. Registration number http://ClinicalTrials.gov number, NCT00536887.
    • Molecular Sequence:
      ClinicalTrials.gov NCT00536887
    • Accession Number:
      0 (Antigens, CD34)
      0 (Biomarkers)
      0 (CXCR4 protein, human)
      0 (Cholesterol, LDL)
      0 (Cytokines)
      0 (Heptanoic Acids)
      0 (Hydroxymethylglutaryl-CoA Reductase Inhibitors)
      0 (Inflammation Mediators)
      0 (Pyrroles)
      0 (Receptors, CXCR4)
      A0JWA85V8F (Atorvastatin)
    • Publication Date:
      Date Created: 20100508 Date Completed: 20110217 Latest Revision: 20181201
    • Publication Date:
      20240628
    • Accession Number:
      10.1136/hrt.2009.182683
    • Accession Number:
      20448126