급성 심근경색증 환자에서 순환 내피전구세포에 대한 조기 스타틴 치료의 효과

다국어 초록 (Multilingual Abstract)

Background and Objectives: The mobilization of circulating endothelial progenitor cells (EPCs) might represent
a useful strategy for the clinical therapy of ischemic heart disease. We examined the effect of early statin therapy
before reperfusion therapy on the circulating EPCs during the acute phase in patients with acute myocardial infarction
(AMI). Subjects and Methods: A total of 84 consecutive AMI patients undergoing primary percutaneous
coronary intervention (PCI) within 24 hours of pain onset were included in this study. We randomly divided the
patients into 3 groups according to rosuvastatin therapy before PCI: the control group (n:27, 19 males and 8
females, 58±2 years of age), the rosuvastatin 10 mg group (n: 28, 21 males and 7 females, 58±3 years of age)
and the 40 mg group (n: 29, 23 males and 6 females, 59±2 years of age). The circulating EPCs and high
sensitivity C-reactive protein (hs-CRP) levels were analyzed on admission and at 1, 3, 5, 7 and 30 days after PCI.
The circulating EPCs were measured by flow cytometry as the CD45lowCD34+VEGFR2+ cells. Results: The circulating
EPCs peaked on day 3 after PCI, whereas the increment of circulating EPCs was significantly suppressed
in the rosuvastatin 10 mg and 40 mg groups compared with the control group on day 3 (control vs rosuvastatin 10
mg vs rosuvastatin 40 mg: 0.072% vs 0.067% vs 0.061%, respectively, p=0.002) and day 5 (0.068% vs 0.060% vs
0.058%, respectively, p=0.029). The level of hs-CRP markedly increased from day 1 and this peaked on day 3 after
PCI. Early statin therapy significantly suppressed the elevation of hs-CRP compared with the control group
on day 1 (24.36 mg/L vs 17.88 mg/L vs 13.08 mg/L, respectively, p=0.035) and on day 3 (30.15 mg/L vs 22.78 mg/L
vs 17.16 mg/L, respectively, p=0.034). There was a statistically significant correlation between the circulating
EPCs and the hs-CRP (r=0.349, p=0.007). Conclusion: In the AMI patients, the early stain therapy before reperfusion
therapy didn’t increase the mobilization of circulating EPCs, but it suppressed the elevation of hs-CRP.
This data suggests that the mobilization of circulating EPCs may be related to systemic inflammation during the
acute phase in patients with AMI.

다국어 초록 (Multilingual Abstract)

Background and Objectives: The mobilization of circulating endothelial progenitor cells (EPCs) might represent
a useful strategy for the clinical therapy of ischemic heart disease. We examined the effect of early statin therapy
before reperfusion therapy on the circulating EPCs during the acute phase in patients with acute myocardial infarction
(AMI). Subjects and Methods: A total of 84 consecutive AMI patients undergoing primary percutaneous
coronary intervention (PCI) within 24 hours of pain onset were included in this study. We randomly divided the
patients into 3 groups according to rosuvastatin therapy before PCI: the control group (n:27, 19 males and 8
females, 58±2 years of age), the rosuvastatin 10 mg group (n: 28, 21 males and 7 females, 58±3 years of age)
and the 40 mg group (n: 29, 23 males and 6 females, 59±2 years of age). The circulating EPCs and high
sensitivity C-reactive protein (hs-CRP) levels were analyzed on admission and at 1, 3, 5, 7 and 30 days after PCI.
The circulating EPCs were measured by flow cytometry as the CD45lowCD34+VEGFR2+ cells. Results: The circulating
EPCs peaked on day 3 after PCI, whereas the increment of circulating EPCs was significantly suppressed
in the rosuvastatin 10 mg and 40 mg groups compared with the control group on day 3 (control vs rosuvastatin 10
mg vs rosuvastatin 40 mg: 0.072% vs 0.067% vs 0.061%, respectively, p=0.002) and day 5 (0.068% vs 0.060% vs
0.058%, respectively, p=0.029). The level of hs-CRP markedly increased from day 1 and this peaked on day 3 after
PCI. Early statin therapy significantly suppressed the elevation of hs-CRP compared with the control group
on day 1 (24.36 mg/L vs 17.88 mg/L vs 13.08 mg/L, respectively, p=0.035) and on day 3 (30.15 mg/L vs 22.78 mg/L
vs 17.16 mg/L, respectively, p=0.034). There was a statistically significant correlation between the circulating
EPCs and the hs-CRP (r=0.349, p=0.007). Conclusion: In the AMI patients, the early stain therapy before reperfusion
therapy didn’t increase the mobilization of circulating EPCs, but it suppressed the elevation of hs-CRP.
This data suggests that the mobilization of circulating EPCs may be related to systemic inflammation during the
acute phase in patients with AMI.

참고문헌 (Reference)

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