Am J Cardiol:他汀可减少不稳定心绞痛患者冠脉斑块体积

2013-02-05 Am J Cardiol CMT 高晓方 编译

  日本学者的一项研究表明,在不稳定性心绞痛患者中他汀类治疗对冠脉斑块体积的影响更为显著,但其未能阻止斑块易损性进展。论文于2013年1月21日在线发表于《美国心脏病学杂志》(Am J Cardiol)。   此项研究共纳入119例心绞痛患者,其中稳定性和不稳定性心绞痛分别为83和36例。受试者均具备可分析的血管内超声资料。利用虚拟组织学成像血管内超声(VH-VUS)评估8个

  日本学者的一项研究表明,在不稳定性心绞痛患者中他汀类治疗对冠脉斑块体积的影响更为显著,但其未能阻止斑块易损性进展。论文于2013年1月21日在线发表于《美国心脏病学杂志》(Am J Cardiol)。

  此项研究共纳入119例心绞痛患者,其中稳定性和不稳定性心绞痛分别为83和36例。受试者均具备可分析的血管内超声资料。利用虚拟组织学成像血管内超声(VH-VUS)评估8个月他汀类治疗对冠脉粥样硬化的影响。

  结果显示,不稳定性心绞痛患者的斑块体积出现显著减小(P=0.02),稳定性心绞痛患者则无上述改变。仅在不稳定性心绞痛患者中观察到坏死核组分显著减少(P=0.009)。在不稳定心绞痛患者中,血小板活化因子乙酰水解酶变化百分比与斑块体积变化百分比呈显著正相关;在稳定性心绞痛患者中则无显著相关性。多变量回归分析显示,在不稳定心绞痛患者中血小板活化因子乙酰水解酶降低与冠脉粥样硬化减轻具有相关性,并且纤维性组分尤为明显。


Comparison of Change in Coronary Atherosclerosis in Patients With Stable Versus Unstable Angina Pectoris Receiving Statin Therapy (from the Treatment With Statin on Atheroma Regression Evaluated by Intravascular Ultrasound With Virtual Histology [TRUTH] Study)

Although statin-induced regression in coronary atherosclerosis seems to be greater in patients with acute coronary syndrome than in those with stable coronary artery disease, no reports have examined this. The purpose of the present study was to compare the changes in coronary atherosclerosis in patients with stable versus unstable angina pectoris (AP). The effects of 8-month statin therapy on coronary atherosclerosis were evaluated using virtual histology intravascular ultrasound, and analyzable intravascular ultrasound data were obtained from 119 patients (83 patients with stable AP and 36 with unstable AP). A significant decrease in plaque volume was observed in patients with unstable AP (−2.2%, p = 0.02) but not in patients with stable AP. A significant increase in the necrotic-core component (0.30 mm3/mm, p = 0.009) was observed only in patients with unstable AP. Significant positive correlations were observed between the percentage of change in platelet-activating factor acetylhydrolase and the percentage of change in plaque volume (r = 0.346, p = 0.05) in patients with unstable AP. No significant correlations were observed in patients with stable AP. Multivariate regression analyses showed that a reduction in platelet-activating factor acetylhydrolase was associated with regression in coronary atherosclerosis, particularly of the fibrous component (β = 0.443, p = 0.003), in patients with unstable AP. In conclusion, regression of the coronary artery plaque volume was greater, although statin therapy did not halt the increases in plaque vulnerability, in patients with unstable AP compared to those with stable AP. A reduction in the serum platelet-activating factor acetylhydrolase level was associated with regression in coronary atherosclerosis, particularly the fibrous plaque volume, in patients with unstable AP.

    

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