Key result
ACE inhibitors, calcium sensitizers, phosphodiesterase type III inhibitors, and beta-blockers positively affect endothelial function, whereas nitrates have a negative effect in critical circulation.
Why the study?
Endothelial dysfunction drives coronary artery disease and its complications, but not all CAD medications positively affect endothelial function.
How do different classes of cardiovascular drugs affect endothelial function and systemic hemodynamics in patients after myocardial revascularization?
How do different classes of cardiovascular drugs affect endothelial function and systemic hemodynamics in patients after myocardial revascularization?
While ACE inhibitors, calcium sensitizers, PDE III inhibitors, and beta blockers improve endothelial function post-myocardial revascularization, their potential to negatively impact perioperative systemic hemodynamics requires careful clinical application.
Review summarizes CAD drug effects on endothelial function; leaves open which agents merit outcome-focused trials.
Background: Endothelial dysfunction is the main link in the development of cardiovascular diseases, which leads to ischemic heart disease (coronary artery disease) and its complications. There are many medicines available for the treatment of coronary artery disease. However, not all groups of drugs are able to positively affect endothelial function. Purpose. Based on the literature data, to study the effect of the main groups of drugs for the treatment of coronary artery disease on endothelial function and systemic hemodynamics in cardiac surgery patients after myocardial revascularization. Material and methods: The review and analysis of literature data from 46 sources are presented. Results: Angiotensin converting enzyme receptor inhibitors, calcium sensitizers, phosphodiesterase type III inhibitors as well as beta blockers have a positive effect on endothelial function. Nitrates have a negative effect on its function in conditions of critical circulation and should be used with caution in endothelial dysfunction. Conclusion: The data obtained indicate a positive effect of angiotensin converting enzyme receptor inhibitors, calcium sensitizers, type III phosphodiesterase inhibitors and beta blockers on endothelial function. However, these groups of drugs can negatively affect systemic hemodynamics in the perioperative period, which requires a deliberate approach when prescribing them.
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Yakubtsevich et al. (2022) conducted a review in Ischemic heart disease with endothelial dysfunction undergoing myocardial revascularization. Cardiovascular drugs (ACE inhibitors, beta-blockers, calcium sensitizers, nitrates, PDE III inhibitors) was evaluated on Endothelial function and systemic hemodynamics. ACE inhibitors, calcium sensitizers, phosphodiesterase type III inhibitors, and beta-blockers positively affect endothelial function, whereas nitrates have a negative effect in critical circulation.
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