Effect of Fluvastatin on Progression of Coronary Atherosclerotic Plaque Evaluated by Virtual Histology Intravascular Ultrasound
Effect of Fluvastatin on Progression of Coronary Atherosclerotic Plaque Evaluated by Virtual Histology Intravascular Ultrasound
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DOI：
10.1016/j.jcin.2009.04.016
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发表时间：
2009-07-01
影响因子：
11.3
通讯作者：
Suzuki, Takahiko
中科院分区：
文献类型：
--
作者：
Nasu, Kenya;Tsuchikane, Etsuo;Suzuki, Takahiko
目的本研究的目的是通过连续容积虚拟组织学（VH）血管内超声（IVUS）评价他汀类药物治疗对非罪犯血管冠状动脉粥样硬化斑块进展的影响。然而，他汀类药物治疗是否影响斑块成分的变化仍不清楚。将80例稳定型心绞痛患者根据总胆固醇或低密度脂蛋白胆固醇水平分为氟伐他汀组（n = 40）和对照组（n = 40）。在基线和12个月的follow-up.Results的LDL胆固醇和高敏C-反应蛋白（hsCRP）水平在氟伐他汀组的每一个斑块成分（致密钙，纤维组织，纤维脂肪，或坏死核心）的体积进行了评估，在随访时显着降低。在VH IVUS结果中，纤维脂肪体积显著减少（基线80.1 ± 57.9 mm（3）vs.随访32.5 ± 27.7 mm（3），p < 0.0001），纤维组织体积增加（基线146.5 ± 85.6 mm（3）vs.随访163.3 ± 94.5 mm（3），p < 0.0001）。在对照组中，无纤维组织的所有斑块成分的体积均显著增加。纤维脂肪体积的变化与LDL胆固醇水平的变化（R = 0.703，p < 0.0001）和hsCRP水平的变化（R = 0.357，p = 0.006）显著相关。结论氟伐他汀降脂治疗1年后，动脉粥样硬化斑块体积明显缩小，纤维脂肪体积明显减少，斑块成分发生改变。（J Am科尔心脏病学Intv 2009;2：689-96）（C）美国心脏病学会基金会2009年
Objectives The aim of this study was to evaluate the effect of treatment with statins on the progression of coronary atherosclerotic plaques of a nonculprit vessel by serial volumetric virtual histology (VH) intravascular ultrasound (IVUS).Background Recent clinical trials have demonstrated a reduction of atherosclerotic plaque, yet whether statin therapy affects the change in components of plaque remains unknown.Methods This study was a nonrandomized and nonblinded design. Eighty patients with stable angina pectoris were divided into either the fluvastatin group (n = 40) or the control group (n = 40) according to their total or low-density lipoprotein (LDL) cholesterol level. The volume of each plaque component (dense calcium, fibrous tissue, fibro-fatty, or necrotic core) was evaluated at baseline and at 12-month follow-up.Results The LDL cholesterol and high-sensitivity C-reactive protein (hsCRP) levels in the fluvastatin group were significantly decreased at time of follow-up. In VH IVUS findings, fibro-fatty volume was significantly decreased (baseline 80.1 +/- 57.9 mm(3) vs. follow-up 32.5 +/- 27.7 mm(3), p < 0.0001) and fibrous tissue volume was increased (baseline 146.5 +/- 85.6 mm(3) vs. follow-up 163.3 +/- 94.5 mm(3), p < 0.0001) in the fluvastatin group. In the control group, the volumes of all plaque components without fibrous tissue were significantly increased. Change in fibro-fatty volume has a significant correlation with a change in LDL cholesterol level (R = 0.703, p < 0.0001) and change in hsCRP level (R = 0.357, p = 0.006).Conclusions One-year lipid-lowering therapy by fluvastatin showed significant regression of plaque volume and alterations in atherosclerotic plaque composition with a significant reduction of fibro-fatty volume. (J Am Coll Cardiol Intv 2009;2:689-96) (C) 2009 by the American College of Cardiology Foundation