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首页> 外文期刊>The American Journal of Cardiology >Comparison of Intensive Versus Moderate Lipid-Lowering Therapy on Fibrous Cap and Atheroma Volume of Coronary Lipid-Rich Plaque Using Serial Optical Coherence Tomography and Intravascular Ultrasound Imaging
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Comparison of Intensive Versus Moderate Lipid-Lowering Therapy on Fibrous Cap and Atheroma Volume of Coronary Lipid-Rich Plaque Using Serial Optical Coherence Tomography and Intravascular Ultrasound Imaging

机译：串行光学相干断层扫描和血管内超声成像对比纤维冠状动脉粥样硬化斑块的纤维帽和动脉粥样硬化容积强化降脂治疗与中度降脂治疗的比较

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Despite marked clinical benefit, reduction in atheroma volume with statin therapy is minimal. Changes in plaque composition may explain this discrepancy. We aimed in the present study to assess the effect of statin therapy on coronary plaque composition and plaque volume using serial multimodality imaging. From an open-label, single-blinded study, patients with angiographically mild-to-moderate lesion were randomized to receive atorvastatin 60 (AT 60) mg or atorvastatin 20 (AT 20) mg for 12 months. Optical coherence tomography was used to assess fibrous cap thickness (FCT) and intravascular ultrasound to assess atheroma burden at 3 time points: baseline, at 6 months, and at 12 months. Thirty-six lipid-rich plaques in 27 patients with AT 60 mg and 30 lipid-rich plaques in 19 patients with AT 20 mg were enrolled in this study. Low-density lipoprotein cholesterol level was significantly decreased at 6 months without further reduction at 12 months. AT 60 mg induced greater reduction in low-density lipoprotein cholesterol compared with AT 20 mg. Optical coherence tomography revealed continuous increase in FCT from baseline to 6 months and to 12 months in both groups. AT 60 mg induced greater increase in FCT compared with AT 20 mg at both follow-up points. The prevalence of thin-cap fibroatheroma and the presence of macrophage at 6 months were significantly lower in AT 60 mg compared with AT 20 mg. Plaque burden did not change significantly in both groups. In conclusion, both intensive and moderate statin therapy stabilizes coronary plaques, with a greater benefit in the intensive statin group. However, no significant changes in plaque volume were observed over time regardless of the intensity of statin therapy. (C) 2016 Elsevier Inc. All rights reserved.
机译：尽管有明显的临床益处，但他汀类药物治疗减少的动脉粥样硬化体积最小。斑块组成的变化可以解释这种差异。在本研究中，我们旨在通过串联多模态成像评估他汀类药物治疗对冠状动脉斑块成分和斑块体积的影响。从一项开放标签，单盲研究中，将血管造影轻至中度病变的患者随机分配接受阿托伐他汀60（AT 60）毫克或阿托伐他汀20（AT 20）毫克，为期12个月。光学相干断层扫描用于评估纤维帽厚度（FCT），血管内超声评估3个时间点的动脉粥样硬化负荷：基线，6个月和12个月。本研究招募了27例AT 60 mg的患者中的36个富脂质斑块和19例AT 20 mg的患者中的30个富脂质斑块。低密度脂蛋白胆固醇水平在6个月时显着降低，而在12个月时没有进一步降低。与AT 20 mg相比，AT 60 mg诱导的低密度脂蛋白胆固醇降低更大。光学相干断层扫描显示两组的FCT从基线持续增加至6个月和12个月。在两个随访时间点，AT 60 mg诱导的FCT均高于AT 20 mg。与AT 20 mg相比，AT 60 mg的薄帽纤维状动脉瘤的患病率和6个月时巨噬细胞的存在显着降低。两组的牙菌斑负担没有明显变化。总之，强化和中度他汀类药物疗法均能稳定冠状动脉斑块，在强化他汀类药物组中获益更大。但是，无论他汀类药物的治疗强度如何，随着时间的推移，噬菌斑体积均无明显变化。 （C）2016 Elsevier Inc.保留所有权利。

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