Background and Objectives : Vasospastic angina was correlated with endothelial dysfunction. We compared endothelial functions using flow-mediated vasodilatation (FMD) and circulating endothelial progenitor cell (EPC) between patients with vasospasm and those without and studied the effect of statin on the changes of FMD and EPC in vasospastic angina patients.
Subjects and Methods : In 133 patients who underwent ergonovine provocation test, endothelial functions were compared according to the presence or absence of spasm. The patients in whom coronary spasm was induced were randomly assigned to either the 10mg rosuvastatin group or the placebo group. We compared change in the FMD and EPC level for 6 months from the baseline between the two groups.
Results : The incidence of smoker was higher in vasospastic angina patients than in those without spasm (p<0.001). EPC number (68.6±36.1 vs. 103.7±39.3/200㎕, p<0.001) and FMD (7.1±4.5 vs. 8.6±3.6%, p=0.044) were significantly lower in patients with coronary spasm than in those without spasm. After 6 months’ rosuvastatin treatment, the numbers of CD45lowCD34+VEGFR2+ cells, which was defined by EPC, increased significantly from 73.1±37.8/200㎕ to 99.1±37.8/200㎕ (p=0.002). FMD significantly ameliorated from 7.3±4.1 to 9.3±3.4% after 6 months’ treatment (p<0.001). FMD was correlated with EPC counts before treatment (r=0.229, p=0.049) and after 6 months’ treatment (r=0.268, p=0.020).
Conclusion : The numbers of circulating EPC and FMD were reduced in vasospastic angina, and statin treatment could increase EPC number and FMD. EPC level was correlated with FMD. So, Circulating EPC may play the role of a biologic marker for endothelial functions in patients with vasospastic angina.
|
