Changes in carotid plaque tissue composition in subjects who continued and discontinued statin therapy
Changes in carotid plaque tissue composition in subjects who continued and discontinued statin therapy
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继续和停止他汀类药物治疗的受试者颈动脉斑块组织成分的变化
DOI：
10.1016/j.jacl.2016.01.004
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发表时间：
2016-06-01
影响因子：
4.4
通讯作者：
Ye, Ping
中科院分区：
文献类型：
--
作者：
Du, Ruixue;Zhao, Xue-Qiao;Ye, Ping
背景技术背景：斑块组织成分的变化，如富含脂质的坏死核心（LRNC）和纤维组织与长期他汀类药物治疗或停药还没有研究过。目的：通过磁共振成像评价LRNC和纤维组织在受试者谁继续和停止他汀类药物治疗2年后的前瞻性研究。在32例脂质治疗初治受试者中开展的动脉粥样硬化中国患者瑞舒伐他汀评价研究显示，瑞舒伐他汀治疗24个月期间LRNC显著降低。在完成动脉粥样硬化中国患者的瑞舒伐他汀评价后，15例受试者继续服用他汀类药物，17例受试者尽管接受了继续他汀类药物治疗的指导，但仍停药。结果：他汀类药物组48个月时LRNC体积及成分较24个月时明显减少，但与对照组相比差异无统计学意义（101 76 vs 76 65 mm（3）; P = 0.001和17.3 +/- 11.9% vs 12.6 +/- 7.6%; P = 0.04），而纤维组织在两个体积中均显著增加（337 160 vs 357 169 mm 3; P < .001）和组成（76.3 +/- 10.5% vs 83.1 +/-10.1%，P = .002）。在停用他汀类药物的受试者中未观察到此类变化。此外，24至48个月期间，他汀类药物持续治疗组和停止治疗组之间LRNC体积和组成以及纤维组织组成的变化存在显著差异（-25 +/- 18 vs 9 +/- 14 mm 3; P < .001）和（-4.6 +/- 8.2% vs 1.3 +/- 2.8%; P = .009）和（6.9 +/-6.8%vs 1.3 +/-5.4%，P = 0.018）结论：持续他汀类药物治疗导致LRNC持续降低和纤维组织增加，这表明斑块稳定性改善，支持长期他汀类药物治疗。(C)2016年全国脂质协会。All rights reserved.
BACKGROUND: Changes in plaque tissue components such as lipid-rich necrotic core (LRNC) and fibrous tissue with long-term statin treatment or discontinuation have not been studied.OBJECTIVE: LRNC and fibrous tissue by magnetic resonance imaging were evaluated in subjects who continued and discontinued statin therapy for 2 years after a prospective study.METHODS: The Rosuvastatin Evaluation of Atherosclerotic Chinese Patients study in 32 lipid treatment naive subjects showed a significant reduction in LRNC during 24 months of rosuvastatin therapy. After Rosuvastatin Evaluation of Atherosclerotic Chinese Patients was completed, 15 subjects continued taking statins and 17 discontinued despite receiving an instruction to continue statin therapy. LRNC and fibrous tissue were compared between 24 and 48 months within each group and between the 2 groups.RESULTS: At 48 months, LRNC volume and composition decreased significantly compared with that at 24 months in the statin-continued group (101 76 vs 76 65 mm(3); P = .001 and 17.3 +/- 11.9% vs 12.6 +/- 7.6%; P = .04), whereas fibrous tissue increased significantly in both volume (337 160 vs 357 169 mm3; P < .001) and composition (76.3 +/- 10.5% vs 83.1 +/- 10.1%, P = .002). Such changes were not seen in subjects who discontinued statin. Furthermore, the changes in LRNC volume and composition and fibrous tissue composition from 24 to 48 months were significantly different between the statin-continued and-discontinued groups (-25 +/- 18 vs 9 +/- 14 mm3; P < .001) and (-4.6 +/- 8.2% vs 1.3 +/- 2.8%; P = .009) and (6.9 +/- 6.8% vs 1.3 +/- 5.4%, P = .018).CONCLUSIONS: Continued statin therapy leads to continued decrease in LRNC and increase in fibrous tissue, which indicates improved plaque stability and supports long-term statin therapy. (C) 2016 National Lipid Association. All rights reserved.