Impact of statin therapy on coronary plaque composition: a systematic review and meta-analysis of virtual histology intravascular ultrasound studies.
Impact of statin therapy on coronary plaque composition: a systematic review and meta-analysis of virtual histology intravascular ultrasound studies.
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DOI：
10.1186/s12916-015-0459-4
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发表时间：
2015-09-18
期刊：
影响因子：
9.3
通讯作者：
Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group
中科院分区：
文献类型：
--
作者：
Banach M;Serban C;Sahebkar A;Mikhailidis DP;Ursoniu S;Ray KK;Rysz J;Toth PP;Muntner P;Mosteoru S;García-García HM;Hovingh GK;Kastelein JJ;Serruys PW;Lipid and Blood Pressure Meta-analysis Collaboration (LBPMC) Group
虚拟组织学血管内超声（VH-IVUS）成像是冠状动脉粥样硬化形态学评价的创新工具。他汀类药物治疗对VH-IVUS参数影响的证据尚不确定。因此，我们进行了系统回顾和荟萃分析，以调查他汀类药物治疗对斑块体积及其成分的影响，使用VH-IVUS。检索包括PubMed、科克伦图书馆、Scopus和Embase（截至2014年11月30日），以确定使用VH-IVUS研究他汀类药物治疗对斑块体积及其组成的影响的前瞻性研究。我们确定了9项研究，包括16个他汀类药物治疗组和830名参与者。他汀类药物治疗在减少斑块体积方面有显著效果（标准化平均差（SMD）：−0.137，95%置信区间（CI）：−0.255，−0.019; P = 0.023），外弹性膜体积（SMD：−0.097，95% CI：−0.183，−0.011; P = 0.027），但不是管腔容积（SMD：−0.025，95% CI：−0.110，+0.061; P = 0.574）。纤维斑块体积明显减少（SMD：−0.129，95%CI：−0.255，−0.003; P = 0.045）和致密钙体积增加（SMD：+0.229，95%CI：+0.008，+0.450; P = 0.043），而纤维脂肪（SMD：−0.247，95% CI：−0.592，+0.098; P = 0.16）和坏死核心（SMD：+0.011，95% CI：−0.144，+0.165; P = 0.892）组织体积无统计学显著性。这项荟萃分析表明，他汀类药物治疗对斑块和外弹性膜体积以及纤维和致密钙体积有显著影响。对管腔体积、纤维脂肪和坏死组织体积无影响。
Virtual histology intravascular ultrasound (VH-IVUS) imaging is an innovative tool for the morphological evaluation of coronary atherosclerosis. Evidence for the effects of statin therapy on VH-IVUS parameters have been inconclusive. Consequently, we performed a systematic review and meta-analysis to investigate the impact of statin therapy on plaque volume and its composition using VH-IVUS. The search included PubMed, Cochrane Library, Scopus and Embase (through 30 November 2014) to identify prospective studies investigating the effects of statin therapy on plaque volume and its composition using VH-IVUS. We identified nine studies with 16 statin treatment arms and 830 participants. There was a significant effect of statin therapy in reducing plaque volume (standardized mean difference (SMD): −0.137, 95 % confidence interval (CI): −0.255, −0.019; P = 0.023), external elastic membrane volume (SMD: −0.097, 95 % CI: −0.183, −0.011; P = 0.027) but not lumen volume (SMD: −0.025, 95 % CI: −0.110, +0.061; P = 0.574). There was a significant reduction in fibrous plaque volume (SMD: −0.129, 95 % CI: −0.255, −0.003; P = 0.045) and an increase of dense calcium volume (SMD: +0.229, 95 % CI: +0.008, +0.450; P = 0.043), while changes in fibro-fatty (SMD: −0.247, 95 % CI: −0.592, +0.098; P = 0.16) and necrotic core (SMD: +0.011, 95 % CI: −0.144, +0.165; P = 0.892) tissue volumes were not statistically significant. This meta-analysis indicates a significant effect of statin therapy on plaque and external elastic membrane volumes and fibrous and dense calcium volumes. There was no effect on lumen volume, fibro-fatty and necrotic tissue volumes.