Pharmacological correction of endothelium functional state in patients with atherosclerotic peripheral artery occlusive disease

Abstract

Aim. To evaluate the effects of medications of different pharmacological groups on endothelial cells in patients with atherosclerotic peripheral artery occlusive disease. Methods. The study included 116 patients with atherosclerotic peripheral artery occlusive disease. Patients were divided into 4 groups depending on the taken drug (first group - 29 patients receiving L-arginine; second group - 30 patients, perindopril; third group - 28 patients, losartan; fourth group - 29 patients, nebivolol). Levels of the main biochemical markers reflecting the endothelium functional state were evaluated in all patients on admission to the hospital and 1, 3, and 6 months after the beginning of treatment. Results. All studied drugs stimulated nitric oxide (II) release (р 0.05). The highest increase of nitric oxide (II) level was found in patients receiving nebivolol and losartan. Levels of endothelin-1 tended to decrease in all patients. Superoxide dismutase level change was different both by number and trend in different groups; however, by the 6th month its level has lined up in all of the study groups. Lipid peroxidation parameters variation showed the same tendency as superoxide dismutase level variation. No significant changes in ankle-brachial index were found (р 0.05). Treadmill test showed a statistically significant improvement of pain-free walking distance by approximately 25-30% by the 3rd month of treatment (р 0.05). Conclusion. The studied medications influence endothelial cells and correct the endothelial cells functional state, reflected by change of all biochemical markers levels.