| Objectives:1.To observe the role of different doses of rosuvastatin on the number of circulating endothelial progenitor cells (CEPCs) at24hours before coronary angiography (CAG),and to explore the mechanism of therapeutic benefit of high-dose statin before percutaneous coronary intervention(PCI).2.To observe the dynamic changes of the numbers of CEPCs、KDR+cells and CD34+cells within24h after PCI, and to explore the effect of PCI on the numbers of these cells and the role of them in coronary endothelial damage repair.Methods:1.42cases who were to undergo CAG were randomly divided into two groups:10mg group(n=20) and20mg group (n=22). All cases taken rosuvastatin at a draught. Before treatment and24hours later (before CAG), flow cytometry was used to test the number of CEPCs. According to the results of CAG, the two groups were respectively divided into two subgroups:coronary artery disease(CHD) group and CAG negative group.2. According to whether receive interventional treatment,28cases with suspected unstable angina undergoing elective CAG were divided into2groups:intervention group (n=22) and non-PCI group(n=6).2mL of peripheral blood were taken from the cases of intervention group at the time of0h、3h、5h、7h、24h after the first balloon expansion.2mL of peripheral blood were taken from the cases of non-PCI group at the time of0h、7h、24h after CAG. The peripheral blood were used to detect the numbers of CEPCs、KDR+cells and CD34+cells.Results:1. After treatment,the numbers of CEPCs in two groups were not significantly changed(10mg group:49.95±24.57vs42.95±21.18,P>0.05;20mg group:57.68±17.62vs48.32±22.47,P>0.05).No significant difference was found in the changed numbers of CEPCs between lOmg group and20mg group (7.00±18.94vs9.36±22.44,P>0.05).The subgroup analysis showed that the number of CEPCs in CHD group was significantly higher than before after treatment with20mg rosuvastatin (56.92±12.27 vs42.08±21.27,P<0.05);2. The number of CEPCs in the intervention group increased at1h after PCI then reduced down to the bottom at7h.It increased again at24h after PCI. The number of CEPCs increased at24h after PCI by111%compared to0h (58.71±51.82vs27.77±22.89, P<0.05) and by109%compared to7h (58.71±51.82vs28.05±28.03, P<0.01); The number of CEPCs of non-PCI group is significantly higher than intervention group at0h (40.75±10.91vs27.77±22.89),but there was no significant difference(P>0.05).However,the numbers of CEPCs at each time points did not show a time-dependent changes in the non-PCI group.3. The number of CD34+cells in interventional group did not change during7h after PCI.However, at24h, it increased by79%compared with0h (369.09±219.25vs206.41±133.52,P<0.01).The number of CD34+cells of non-PCI group is significantly higher than intervention group at0h(520.50±201.46vs206.41±133.52, P<0.01).But there was no significant difference in the number of CD34+cells at different time points of non-PCI group. It did not show a time-dependent changes in the non-PCI group.4. The number of KDR+cells of intervention group decrease to the minimize level at7h by94%compared to0h (66.25±14.51vs1629.59±1258.07,P<0.01). There is an upward trend after7h, the number of KDR+cells is higher than7h (201.64±162.69vs99.86±87.41,P<0.05); The number of KDR+cells of non-PCI group is significantly lower than intervention group at0h (99.86±87.41vs1629.59±1258.07,P<0.01).The numbers of KDR+cells at different time points did not show a time-dependent changes in the non-PCI group.Conclusions:1.Taking20mg rosuvastatin in patients with CHD at24h before PCI increases the number of CEPCs, which may be one of the mechanisms of benefit of high-dose statin therapy before PCI.2.Patients with severer CHD have higher level of KDR+cells and lower level of CD34+cells.3. The numbers of CEPCs、KDR+cells and CD34+cells in patients with unstable angina after interventional has a time-dependent change. The number of CEPCs increased at1h after PCI then reduced down to the bottom at7h.Then it increased again at24h after PCI; The number of CD34+cells did not change over time after PCI, but it increased at24h. The number of KDR+cells decrease to the minimize level at7h and there is an upward trend after7h; Endothelial injury induced by PCI causes a time-dependent changes of CEPCs and promote the mobilization, migration, differentiation, homing of them,while promoting the mobilization and differentiation of CD34+stem cells,causing a decline of the number of KDR+cells. |
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