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Simvastatin attenuates leucocyte–endothelial interactions after coronary revascularisation with cardiopulmonary bypass
  1. M Chello1,
  2. P Mastroroberto2,
  3. G Patti1,
  4. A D’Ambrosio1,
  5. M Cortez Morichetti1,
  6. G Di Sciascio1,
  7. E Covino1
  1. 1Interdisciplinary Centre for Biomedical Research (CIR), Department of Cardiovascular Sciences, University Campus Bio-Medico di Roma, Rome, Italy
  2. 2Department of Clinical and Experimental Medicine, University of Catanzaro, Catanzaro, Italy
  1. Correspondence to:
    Dr Massimo Chello, Department of Cardiac Surgery, University Campus Bio Medico di Roma, Via E Longoni 83, Rome 00155, Italy;


Objective: To investigate the effects of preoperative simvastatin treatment on leucocyte–endothelial interactions following coronary artery bypass surgery with cardiopulmonary bypass.

Design: Double 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.

Setting: University hospital (tertiary referral centre).

Patients: Three 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 measures: Expression of neutrophil CD11b and endothelial P-selectin; adhesion of neutrophils to endothelium.

Results: Cardiopulmonary 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.

Conclusions: Pretreatment with simvastatin reduces neutrophil adhesion to the venous endothelium in patients undergoing coronary surgery, irrespective of its efficacy at lowering cholesterol concentration.

  • simvastatin
  • coronary artery bypass
  • neutrophil adhesion
  • CABG, coronary artery bypass graft surgery
  • eNOS, endothelial nitric oxide synthase HMG-CoA, 3-hydroxy 3-methyl-glutaryl coenzyme-A
  • L-NAME, NG-nitro-L-arginine methyl ester
  • NO, nitric oxide

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