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Ann Thorac Surg 1999;67:1277-1282
© 1999 The Society of Thoracic Surgeons

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Original Articles

Inhibition by dipyridamole of neutrophil adhesion to vascular endothelium during coronary bypass surgery

^a Unit of Cardiovascular Surgery, Department of Experimental and Clinical Medicine, Medical School of Catanzaro, Catanzaro, Italy
^b Unit of Clinical Chemistry, Department of Experimental and Clinical Medicine, Medical School of Catanzaro, Catanzaro, Italy

Accepted for publication October 26, 1998.

Address reprint requests to Dr Chello, Via S. Giacomo dei Capri 29, 80128 Naples, Italy
e-mail: chello{at}unicz.it

Background. Release of reactive oxygen radicals by activated neutrophils and neutrophil adhesion to endothelial cells have been observed after cardiopulmonary bypass. The aim of the present study was to evaluate the effects of preoperative dipyridamole treatment on neutrophil superoxide anion generation and endothelial cell–neutrophil interactions.

Methods. Two groups of patients scheduled for elective coronary artery bypass grafting were randomized to receive oral dipyridamole or a placebo. Nitro blue tetrazolium scores of circulating neutrophils, neutrophil CD11b/CD18 expression, and their adhesion to human umbilical vein endothelial cells were assayed before anesthesia, 30 minutes after the beginning of cardiopulmonary bypass, at the end of bypass, and 60 minutes postoperatively.

Results. In both groups, cardiopulmonary bypass resulted in a significant increase in nitro blue tetrazolium scores in circulating neutrophils as well as a significant increase in both neutrophil CD11b/CD18 expression and neutrophil adhesion to endothelial cells. The extent of neutrophil superoxide anion generation was higher in the control group; a significant (p < 0.01) reduction in neutrophil adhesion to endothelial cells was observed 1 hour postoperatively in the dipyridamole group. In 5 patients treated with dipyridamole, the incubation of activated polymorphonuclear leukocytes with adenosine deaminase significantly increased their adhesion to endothelial cells (p < 0.05).

Conclusions. Our study demonstrated that preoperative treatment with oral dipyridamole significantly reduces both neutrophil superoxide anion generation and extent of neutrophil adhesion to endothelial cells after coronary bypass grafting procedures with cardiopulmonary bypass. The mechanism is probably mediated by endogenous adenosine.

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				M Chello, P Mastroroberto, G Patti, A D'Ambrosio, M C. Morichetti, G Di Sciascio, and E Covino Simvastatin attenuates leucocyte-endothelial interactions after coronary revascularisation with cardiopulmonary bypass Heart, May 1, 2003; 89(5): 538 - 543. [Abstract] [Full Text] [PDF]