Rapid stabilization of vulnerable carotid plaque within 1 month of pitavastatin treatment in patients with acute coronary syndrome
Rapid stabilization of vulnerable carotid plaque within 1 month of pitavastatin treatment in patients with acute coronary syndrome
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DOI：
10.1097/fjc.0b013e318165dcad
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发表时间：
2008-04-01
影响因子：
3
通讯作者：
Kugiyama, Kiyotaka
中科院分区：
文献类型：
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作者：
Nakamura, Takamitsu;Obata, Jun-ei;Kugiyama, Kiyotaka
我们确定了急性冠状动脉综合征（ACS）患者通过他汀类药物治疗后颈动脉斑块稳定的时间过程。 65 名患有 Echoluceit 颈动脉斑块的患者在 ACS 发病后 3 天内开始接受 4 mg/d 匹伐他汀 (n = 33) 或安慰剂 (n = 32) 治疗。在所有患者的治疗前和治疗后 1 个月，通过使用颈动脉超声和积分反向散射 (IBS) 分析测量斑块回声来评估易损颈动脉斑块。两组治疗后第 I 个月时易损颈动脉斑块的校准 IBS 值（内膜-中层 IBS 值减去外膜 IBS）均发生有利变化，但匹伐他汀组在第 I 个月的回声透明度比安慰剂组改善更多（匹伐他汀组：治疗前 -18.7 +/- 3.3 dB 对比第 I 个月时 -12.7 +/- 2.3 dB *P < 0.001；安慰剂： -19.0 +/- 3.5 dB 对比 -16.9 +/- 3.2 dB，P < 0.05，*P < 0.01 对比安慰剂组第 I 个月的值。匹伐他汀组第 1 个月的 CRP、VEGF 和 TNF α 水平显着低于安慰剂组。总之，匹伐他汀在治疗 1 个月内改善了 ACS 患者的颈动脉斑块回声透明度，并与易损斑块相关的炎症生物标志物减少相关。
We determined time course of stabilization of echolucent carotid plaques by statin therapy in patients with acute coronary syndrome (ACS). Treatment with 4 mg/d pitavastatin (n = 33) or placebo (n = 32) was initiated within 3 days after onset of ACS in 65 patients with echoluceit carotid plaque. Vulnerable carotid plaques were assessed by measuring plaque echolucency using carotid ultrasound with integrated backscatter (IBS) analysis before and 1 month after treatment in all patients. The calibrated IBS value (intima-media IBS value minus adventias IBS) of vulnerable carotid plaques favorably changed at I month after treatment in both groups, but the echolucency at I month improved more in the pitavastatin than in the placebo group (pitavastatin group: -18.7 +/- 3.3 dB at pretreatment versus -12.7 +/- 2.3 dB at I month *P < 0.001; placebo: -19.0 +/- 3.5 dB versus -16.9 +/- 3.2 dB, P < 0.05, *P < 0.01 versus the value at I month in placebo group). Levels of CRP, VEGF, and TNF alpha at I month were significantly lower in pitavastatin than placebo group. In conclusion, pitavastatin improved carotid plaque echolucency within I month of therapy in patients with ACS, in association with decrease in the inflammatory bionnarkers related to vulnerable plaques.