Effect of Intensive Statin Therapy on Coronary High-Intensity Plaques Detected by Noncontrast T1-Weighted Imaging The AQUAMARINE Pilot Study
Effect of Intensive Statin Therapy on Coronary High-Intensity Plaques Detected by Noncontrast T1-Weighted Imaging The AQUAMARINE Pilot Study
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DOI：
10.1016/j.jacc.2015.05.056
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发表时间：
2015-07-21
影响因子：
24
通讯作者：
Yasuda, Satoshi
中科院分区：
文献类型：
--
作者：
Noguchi, Teruo;Tanaka, Atsushi;Yasuda, Satoshi
背景：冠状动脉T1加权成像检测到的高密度斑块可能代表斑块的不稳定性。高强度斑块可通过斑块与心肌信号强度比（PMR）定量评估。结论本试验性假设研究旨在调查强化他汀类药物治疗是否会降低PMR。方法对48例冠心病患者进行前瞻性系列非对比T1加权磁共振成像和计算机断层扫描血管造影，基线和强化匹伐他汀治疗12个月后，目标低密度脂蛋白胆固醇水平<80 mg/dl。对照组由未接受他汀类药物治疗的冠状动脉疾病患者组成，其倾向评分匹配（n = 48）。主要终点是PMR的12个月变化。结果：他汀类药物治疗组中，他汀类药物治疗12个月后，低密度脂蛋白胆固醇水平明显改善（125至70 mg/dl; p <0.001），PMR（1.38至1.11，减少18.9%; p <0.001），低衰减斑块体积，以及计算机断层扫描显示的总粥样硬化体积百分比。在对照组中，PMR显著增加（从1.22增加到1.49，增加19.2%; p <0.001）。PMR的变化与低密度脂蛋白胆固醇的变化相关（r = 0.533; p <0.001），高敏C反应蛋白（r = 0.347; p <0.001），动脉粥样硬化体积百分比（r = 0.477; p <0.001）和低密度斑块体积百分比（r = 0.416; p <0.001）。非对比T1加权磁共振成像可能成为一种有用的技术，重复定量评估斑块的组成。(C)2015年由美国心脏病学会基金会。
BACKGROUND Coronary high-intensity plaques detected by noncontrast T1-weighted imaging may represent plaque instability. High-intensity plaques can be quantitatively assessed by a plaque-to-myocardium signal-intensity ratio (PMR).OBJECTIVES This pilot, hypothesis-generating study sought to investigate whether intensive statin therapy would lower PMR. METHODS Prospective serial noncontrast T1-weighted magnetic resonance imaging and computed tomography angiography were performed in 48 patients with coronary artery disease at baseline and after 12 months of intensive pitavastatin treatment with a target low-density lipoprotein cholesterol level < 80 mg/dl. The control group consisted of coronary artery disease patients not treated with statins that were matched by propensity scoring (n = 48). The primary endpoint was the 12-month change in PMR. Changes in computed tomography angiography parameters and high-sensitivity C-reactive protein levels were analyzed.RESULTS In the statin group, 12 months of statin therapy significantly improved low-density lipoprotein cholesterol levels (125 to 70 mg/dl; p < 0.001), PMR (1.38 to 1.11, an 18.9% reduction; p < 0.001), low-attenuation plaque volume, and the percentage of total atheroma volume on computed tomography. In the control group, the PMR-increased significantly (from 1.22 to 1.49, a 19.2% increase; p < 0.001). Changes in PMR were correlated with changes in low-density lipoprotein cholesterol (r = 0.533; p < 0.001), high-sensitivity C-reactive protein (r = 0.347; p < 0.001), percentage of atheroma volume (r = 0.477; p < 0.001), and percentage of low-attenuation plaque volume (r = 0.416; p < 0.001).CONCLUSIONS Statin treatment significantly reduced the PMR of high-intensity plaques. Noncontrast T1-weighted magnetic resonance imaging could become a useful technique for repeated quantitative assessment of plaque composition. (C) 2015 by the American College of Cardiology Foundation.