Eicosapentaenoic acid therapy is associated with decreased coronary plaque instability assessed using optical frequency domain imaging
Eicosapentaenoic acid therapy is associated with decreased coronary plaque instability assessed using optical frequency domain imaging
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DOI：
10.1002/clc.23185
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发表时间：
2019-06-01
影响因子：
2.7
通讯作者：
Tanaka, Shinya
中科院分区：
文献类型：
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作者：
Konishi, Takao;Sunaga, Daisuke;Tanaka, Shinya
背景二十碳五烯酸(EPA)治疗与光学频域成像(OFDI)评估冠状动脉斑块稳定性的关系尚未完全描述。假设EPA治疗与使用OFDI进行经皮冠状动脉介入治疗(PCI)的患者的斑块不稳定性降低有关。方法对2015年10月至2018年7月连续行经皮冠状动脉介入治疗的121例患者的冠状动脉斑块资料进行回顾性分析。在这些患者中，109人未接受治疗(非EPA组)，12人接受EPA治疗(EPA组)。用OFDI分析各斑块的形态特征。结果对接受或未接受EPA治疗的患者进行1：4倾向评分匹配。两组的基线特征(年龄、性别、体重指数、糖尿病、高血压、血脂异常、慢性肾脏疾病、吸烟、既往经皮冠状动脉介入治疗或冠状动脉旁路移植术、既往心肌梗死、既往使用他汀类药物、急性冠脉综合征、血红蛋白A1c水平、低密度脂蛋白胆固醇浓度、甘油三酯浓度和高密度脂蛋白胆固醇浓度)平衡。本研究分析了60例患者的对外直接投资数据。EPA组的平均血脂指数(818+/-806vs1574+/-891)和巨噬细胞分级(13.5+/-5.9vs19.3+/-7.4)显著低于非EPA组(P分别为0.010、0.019和0.040)，而平均最小纤维帽厚度(109.2+/-55.7vs81.6+/-36.4µm)明显高于非EPA组(P分别为0.010、0.019和0.040)。多因素Logistic回归分析显示，以前使用环磷酰胺与较低的血脂指数和巨噬细胞分级独立相关(分别为P=0.043和0.024)。结论对外直接投资分析表明，EPA治疗与冠状动脉介入治疗患者的斑块不稳定性降低有关。
Background The relationship between eicosapentaenoic acid (EPA) therapy and coronary plaque stability assessed by optical frequency domain imaging (OFDI) has not been thoroughly described. Hypothesis EPA therapy is associated with decreased plaque instability in patients undergoing percutaneous coronary intervention (PCI) using OFDI. Methods Data on coronary artery plaques from 121 patients who consecutively underwent PCI between October 2015 and July 2018 were retrospectively analyzed. Of these patients, 109 were untreated (no-EPA group), whereas 12 were treated with EPA (EPA group). Each plaque's morphological characteristics were analyzed using OFDI. Results We used 1:4 propensity score matching for patients who received or did not receive EPA therapy before PCI. Baseline characteristics were balanced between both groups (age, sex, body mass index, diabetes mellitus, hypertension, dyslipidemia, chronic kidney disease, smoking, previous PCI or coronary artery bypass grafting, previous myocardial infarction, prior statin use, acute coronary syndrome, hemoglobin A1c level, low-density lipoprotein cholesterol concentration, triglyceride concentration, and high-density lipoprotein cholesterol concentration). OFDI data from 60 patients were analyzed in this study. The EPA group had significantly lower mean lipid index (818 +/- 806 vs 1574 +/- 891) and macrophage grade (13.5 +/- 5.9 vs 19.3 +/- 7.4) but higher mean minimum fibrous cap thickness (109.2 +/- 55.7 vs 81.6 +/- 36.4 mu m) than the no-EPA group (P = 0.010, 0.019, and 0.040, respectively). Multiple logistic regression analyses showed that prior EPA use was independently associated with lower lipid index and macrophage grade (P = 0.043 and 0.024, respectively). Conclusion This OFDI analysis suggests that EPA therapy is associated with decreased plaque instability in patients undergoing PCI.