Review
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jan 26, 2017; 9(1): 1-13
Published online Jan 26, 2017. doi: 10.4330/wjc.v9.i1.1
Endothelial progenitor cells: Exploring the pleiotropic effects of statins
Kully Sandhu, Mamas Mamas, Robert Butler
Kully Sandhu, Mamas Mamas, Robert Butler, Department of Cardiology, Royal Stoke University Hospital, University Hospital of North Midlands, Stafford ST4 6QG, United Kingdom
Author contributions: Sandhu K wrote the paper; Mamas M and Butler R both supervised and reviewed the article.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Kully Sandhu, BSc, DM, MRCP, Cardiology Research Registrar, Department of Cardiology, Royal Stoke University Hospital, University Hospital of North Midlands, Stoke on Trent, Stafford ST4 6QG, United Kingdom. ksandhu@hotmail.com
Telephone: +44-1782-675953 Fax: +44-1782-672780
Received: June 21, 2016
Peer-review started: June 24, 2016
First decision: August 11, 2016
Revised: September 9, 2016
Accepted: November 1, 2016
Article in press: November 2, 2016
Published online: January 26, 2017
Abstract

Statins have become a cornerstone of risk modification for ischaemic heart disease patients. A number of studies have shown that they are effective and safe. However studies have observed an early benefit in terms of a reduction in recurrent infarct and or death after a myocardial infarction, prior to any significant change in lipid profile. Therefore, pleiotropic mechanisms, other than lowering lipid profile alone, must account for this effect. One such proposed pleiotropic mechanism is the ability of statins to augment both number and function of endothelial progenitor cells. The ability to augment repair and maintenance of a functioning endothelium may have profound beneficial effect on vascular repair and potentially a positive impact on clinical outcomes in patients with cardiovascular disease. The following literature review will discuss issues surrounding endothelial progenitor cell (EPC) identification, role in vascular repair, factors affecting EPC numbers, the role of statins in current medical practice and their effects on EPC number.

Keywords: Statins, Endothelial progenitor cells, Pleiotropic effects, Ischaemic heart disease, Pleiotropic mechanisms

Core tip: Statin therapy is a cornerstone of current management in coronary artery disease. Conventional thinking of stain therapy is for reduction of low-density lipoproteins. However a number of studies have observed an early benefit prior to any significant change in lipid profile. Therefore alternative pleiotropic mechanisms to account for this have been proposed. One such proposed mechanism is the ability of statins to augment both number and function of endothelial progenitor cells (EPCs). The following literature review discusses issues surrounding EPC identification, role in vascular repair, the role of statins in current medical practice and their effects on EPCs.