ROSUVASTATIN AND EZETIMIBE IN PATIENTS WITH ISCHEMIC HEART DISEASE AFTER CORONARY ARTERY BYPASS GRAFTING

Objective. To evaluate the relationship between endothelial dysfunction, proinflammatory activity of leucocytes and pleiotropics effects of hypolipidemic therapy by rozuvastatin vs. simvastatin (as monotherapy and in combination with ezetimibe) in patients with coronary artery disease undergoing coronary artery bypass surgery (CABG). Design and methods. Altogether 92 patients with coronary artery disease (study group) and 22 healthy individuals (a control group) were enrolled. Vascular endothelial function was evaluated by brachial artery response assessment (endothelium-dependent vasodilatation test, the method by D. Celermajer and co-authors, Vingmed CPM 800). Proinflammatory activity of leucocytes was measured by chemiluminescent microscopy, and the severity of atherosclerotic coronary lesions was assessed by invasive coronary angiography. Endothelial function, leucocytes activity and lipid levels were determined before CABG and 12 months after revascularization. Results. Patients with coronary artery disease showed more complex disorders involving endothelial dysfunction and higher levels of leucocytes activity. The clinical effect of CABG (absence of angina pectoris and negative result of stress-echo test during 1‑year of follow-up) was found in 80,6 %. Combination lipid lowering therapy (simvastatin 20 mg and ezetimibe 10 mg) and monotherapy by rosuvastatin 10 mg compared to monotherapy by simvastatin 20 mg demonstrated higher efficiency regarding target lipid levels achievement and improvement of endothelial function and stimulated oxidant activity of leucocytes.

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