Effect of smoking cessation on microcirculation and endothelial dysfunction in patients with coronary heart disease.

Introduction. The promotion of quitting smoking in recent years is becoming increasingly popular. Many researchers recognize this measure as the most effective in primary and secondary prevention in cardiac patients. Deep mechanisms, through which the positive effect of quitting smoking is realized, continue to be studied. The authors present the results of their own studies devoted to the consequences of endothelial dysfunction (ED) caused by smoking and rejection of it in patients with ischemic heart disease (IHD), manifested at the level of the microcirculatory bed and microcirculation. Material and methods. A microcirculatory bed of bulbar conjunctiva in 93 patients with acute coronary syndrome (ACS) for 7-10 days of inpatient treatment was examined by computer-assisted video biomicroscopy (CAVBM) method. The average diameter of microvessels, the degree of intravascular red blood cells aggregation and its prevalence in various areas of the conjunctiva were assessed in three groups: quitting smokers (n = 29), smokers (n = 36) and non-smokers (n = 28). The patients were comparable in clinical and laboratory characteristics and the volume of treatment received. Results showed more pronounced manifestations of ED in smokers with IHD. Despite this, after the cessation of smoking, the effects of ED were reduced, which led to a significant increase in the diameter of the arterioles (р<0,0001) and capillaries (р=0,0544) and a decrease in the scale of intravascular red blood cells aggregation. Conclusions. Endothelial dysfunction arising in IHD is exacerbated by smoking. After quitting smoking, ED is significantly reduced. The results substantiate the recommendations for quitting smoking among patients with IHD as a measure ofprimary and secondary prevention of ACS.