Functional state of endothelium and oxidant activity of leucocytes in patients with ischemic heart disease after coronary bypass surgery

Relationship between disorders of endothelial function, proinflammatory activity of leucocytes and effects of therapy with simvastatin or its combination with ezetimibe was studied in 72 patients with ischemic heart disease subjected to coronary artery bypass grafting (CABG). Vascular endothelial function was assessed by ultrasound detection of brachial artery response to its compression, oxidant activity of-leucocytes - by chemiluminescent microscopy, severity of coronary artery atherosclerosis - by invasive coronary angiography. Twenty two healthy individuals comprised control group. Endothelial function, activity of leucocytes, and lipid levels were evaluated before and in 12 months after CABG. Patients with multivessel involvement revealed more complex disorders of endothelial function and higher levels of leucocytes activity compared to patients with single-vessel disease. CABG resulted in disappearance of anginal attacks and negative stress echo test during 1-year observation in 80.6 % of patients. Patients with recurrent angina after CABG had more severe endothelial and leucocytes' disorders. Combined lipid lowering therapy (simvastatin plus ezetimibe) compared to simvastatin alone demonstrated higher efficacy in terms of achievement of target lipid levels, improvement of endothelial function and leucocytes disorders.