Review Article

Diabetes, Endothelial Dysfunction, and Vascular Repair: What Should a Diabetologist Keep His Eye on?

Table 1


ReferenceStudy drugStudy population and designStudy durationFindings

Vasa et al. [77]Atorvastatin 40 mg/day15 patients with coronary artery disease, no control group4 weeks1.5-fold ↑ in EPC count after 1 week  
3-fold ↑ in EPC count after 4 weeks  
↑ EPC functional activity

del Papa et al. [78]Simvastatin 20 mg/day40 patients  
(20 hypercholesterolemic versus  
20 normocholesterolemic patients with systemic sclerosis)
4 weeksSimvastatin ↑ EPC count in patients without systemic sclerosis  
In patients with systemic sclerosis there was an attenuated response, mainly in patients with late disease

Westerweel et al. [79]Simvastatin 80 mg/day versus simvastatin 10 mg/ezetimibe 10 mg/day20 obese patients with metabolic syndrome, randomized trial, crossover design6 + 6 weeks↑ EPC counts in both groups

Pesaro et al. [80]Simvastatin 80 mg/day versus simvastatin 20 mg/ezetimibe 10 mg/day68 patients with LDL levels >70 mg/dL pretreated with simvastatin 20 mg, randomized trial6 weeksNo effect on EPC count in either group  
Similar reduction in LDL levels in both groups

Hibbert et al. [81]Atorvastatin 80 mg/day versus no statin20 male patients undergoing angiography for stent placement randomized to atorvastatin or no statin treatment4 days3.5-fold ↑ in EPC count in the statin group

Baran et al. [82]Atorvastatin 40 mg/day versus placebo60 patients undergoing first-time CABG, placebo controlled, randomized double-blind study14 days↑ EPC count in atorvastatin group  
↓ incidence of postoperative atrial fibrillation in the statin group

Sobrino et al. [83]Atorvastatin 20 mg/day48 patients with first ever nonlacunar ischaemic Stroke  
16 patients receiving atorvastatin during the first 4 days
7 days↑ EPC count in atorvastatin group  
Effect probably due to NO related mechanisms

Huang et al. [84]Atorvastatin 40 mg/day versus atorvastatin 10 mg/day100 patients with ischemic cardiomyopathy randomized to 10 mg or 40 mg of atorvastatin  
Control group: 100 healthy volunteers
1 year40 mg of atorvastatin had a more profound ↑ in EPC count 
Higher dose of atorvastatin was associated with a more marked ↓ in total and LDL cholesterol, hsCRP, oxLDL, and circulating endothelial microparticles

Spadaccio et al. [85]Atorvastatin 20 mg/day versus placebo50 patients undergoing elective coronary surgery, randomized crossover trial3 weeks↑ EPC count in atorvastatin group  
SDF-1α, CSF, and VEGF unaffected

Leone et al. [86]Atorvastatin 80 mg/day immediately versus 20 mg/day atorvastatin after hospital discharge40 patients with AMI undergoing PCI, randomized trial4 monthsLarger dose of atorvastatin related to larger ↑ EPC count  
LV volume, EF, and wall motion were similar in both groups after study completion

Lu et al. [87]Pravastatin versus placebo versus Xuezhikang88 patients with essential hypertension, randomized trial8 weeks↑ EPC count and proliferative ability in pravastatin and Xuezhikang (contains lovastatin) group

Paradisi et al. [88]Pravastatin 40 mg/day20 patients, healthy postmenopausal women, randomized, double-blind trial8 weeks↑ EPC colony forming units  
↓ count of senescent cells

Tousoulis et al. [89]Rosuvastatin 10 mg/day60 patients with systolic heart failure, randomized trial1 month↑ EPC count improved  
No change in inflammatory and oxidative markers

Erbs et al. [90]Rosuvastatin 40 mg/day versus placebo42 patients with chronic heart failure, randomized trial12 weeks↑ EPC count  
↑ homing of EPC  
↑ FMD, ↑VEGF

Yoshida et al. [91]Pitavastatin 2 mg/day versus placebo30 male smokers, randomized trial 4 weeksNo effect on EPC count  
↑ FMD, ↓ markers of oxidative stress in pitavastatin group

Spiel et al. [92]Simvastatin 80 mg/day versus rosuvastatin 10 mg/day versus placebo6 healthy volunteers, randomized, double-blind, placebo controlled, crossover study5 days3-fold ↑ EPC count in statin groups  
Class effect?

Hristov et al. [93]Low dose of statins (10/20 mg/day) versus high dose (40 mg/day) versus untreated209 CAD patients  
(without statin: 65, low dose statin: 101, and higher dose statin: 43 patients) cross-sectional study
None40 mg/d of statin treatment has significantly ↓ EPC count  
Lower doses had no impact on EPC count  
Continuous statin therapy inversely correlated with EPC numbers