Atorvastatin, Etidronate, or Both in Patients at High Risk for Atherosclerotic Aortic Plaques: A Randomized, Controlled Trial
Atorvastatin, Etidronate, or Both in Patients at High Risk for Atherosclerotic Aortic Plaques: A Randomized, Controlled Trial
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DOI：
10.1161/circulationaha.113.001534
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发表时间：
2013-06-11
期刊：
影响因子：
37.8
通讯作者：
Suzuki, Gen
中科院分区：
文献类型：
--
作者：
Kawahara, Tetsuya;Nishikawa, Masako;Suzuki, Gen
背景-他汀类药物是不能有效地减少动脉粥样硬化斑块的腹主动脉，和积累的证据表明，二膦酸盐有可能诱导动脉粥样硬化斑块的腹aortico.Methods和Results-A前瞻性，随机，开放标签，盲终点试验涉及108名参与者与高胆固醇血症进行了回归。参与者每天接受20 mg阿托伐他汀，400 mg依替膦酸盐，或每天两种药物。主要终点是治疗12个月后通过磁共振成像测量的胸、腹主动脉粥样硬化斑块最大血管壁厚度的百分比变化。在联合治疗组和阿托伐他汀组中，胸主动脉的最大血管壁厚度分别降低了13.8%（95%置信区间，-16.4至-11.3）和12.3%（95%置信区间，-14.9至-9.7）。两组的这些降低率相当（P=0.61）。同时，在依替膦酸盐组中，胸主动脉的最大血管壁厚度保持不变（2.2%; 95%置信区间，-0.3至4.8）。相反，联合治疗组（-11.4%）的腹主动脉最大血管壁厚度比阿托伐他汀组（-0.9%; P
Background- Statins are not effective in reducing atherosclerotic plaques of the abdominal aorta, and accumulating evidence suggests that bisphosphonates have the potential to induce the regression of atherosclerotic plaques of the abdominal aorta.Methods and Results- A prospective, randomized, open-label, blinded-end-point trial involving 108 participants with hypercholesterolemia was conducted. Participants received 20 mg atorvastatin daily, 400 mg etidronate daily, or both drugs daily. The primary end point was the percent change in maximal vessel wall thickness of atherosclerotic plaques in the thoracic and abdominal aortas as measured by magnetic resonance imaging after 12 months of treatment. In both the combination therapy and atorvastatin groups, maximal vessel wall thickness of the thoracic aorta was reduced by 13.8% (95% confidence interval, -16.4 to -11.3) and 12.3% (95% confidence interval, -14.9 to -9.7), respectively. These reduction rates were comparable between groups (P=0.61). Meanwhile, in the etidronate group, maximal vessel wall thickness of the thoracic aorta remained unchanged (2.2%; 95% confidence interval, -0.3 to 4.8). Conversely, maximal vessel wall thickness of the abdominal aorta was reduced more effectively in the combination therapy group (-11.4%) than in the atorvastatin group (-0.9%; P