• Heart · May 2003

    Randomized Controlled Trial Clinical Trial

    Simvastatin attenuates leucocyte-endothelial interactions after coronary revascularisation with cardiopulmonary bypass.

    • M Chello, P Mastroroberto, G Patti, A D'Ambrosio, M Cortez Morichetti, G Di Sciascio, and E Covino.
    • Interdisciplinary Centre for Biomedical Research (CIR), Department of Cardiovascular Sciences, University Campus Bio-Medico di Roma, Rome, Italy. m.chello@unicampus.it
    • Heart. 2003 May 1; 89 (5): 538-43.

    ObjectiveTo investigate the effects of preoperative simvastatin treatment on leucocyte-endothelial interactions following coronary artery bypass surgery with cardiopulmonary bypass.DesignDouble blind crossover study. Experiments on polymorphonuclear cells (neutrophils) were done at the end of cardiopulmonary bypass and one hour postoperatively. Endothelial P-selectin expression and neutrophil/endothelial adhesion were evaluated under either normoxic or hypoxic conditions.SettingUniversity hospital (tertiary referral centre).PatientsThree groups of patients undergoing coronary bypass surgery: 20 patients taking simvastatin for cholesterol control, 16 patients not responsive to simvastatin, and 20 controls.Main Outcome MeasuresExpression of neutrophil CD11b and endothelial P-selectin; adhesion of neutrophils to endothelium.ResultsCardiopulmonary bypass resulted in a significant increase in neutrophil CD11b expression in all groups. Similarly, the exposure of saphenous vein to hypoxia/reoxygenation induced an augmentation of endothelial P-selectin. However, both neutrophil CD11b expression and endothelial P-selectin exocytosis were less in the simvastatin groups than in the controls. Cardiopulmonary bypass and controlled hypoxia/reoxygenation stimulated neutrophil/endothelial adhesion, but the number of adhering cells was less in the simvastatin groups than in the controls, irrespective of the cholesterol concentration. Treatment of endothelial cells with L-NAME completely reversed the effects of simvastatin.ConclusionsPretreatment with simvastatin reduces neutrophil adhesion to the venous endothelium in patients undergoing coronary surgery, irrespective of its efficacy at lowering cholesterol concentration.

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