Duivenvoorden Raphael, Nederveen Aart J, de Groot Eric, Kastelein John J P
Department of Vascular Medicine, Academic Medical Center, University of Amsterdam, The Netherlands.
Curr Opin Lipidol. 2007 Dec;18(6):613-21. doi: 10.1097/MOL.0b013e3282f19608.
Imaging of the arterial wall yields validated surrogate markers that can provide an early indication with regards to efficacy of novel cardiovascular drugs. This paper attempts to address the use of atherosclerosis imaging as a benchmarking tool for a well informed decision whether to proceed to large morbidity and mortality studies in the assessment of a novel therapeutic strategy.
Imaging of the artery wall can be used to evaluate individual cardiovascular risk and has additive value over conventional risk scores as it directly addresses the disease process. In controlled clinical trials, vascular imaging has shown that the efficacy of lipid-modifying pharmacotherapy can be evaluated in both high and low-risk populations and that the findings parallel outcomes of clinical studies with similar interventions.
Arterial imaging may provide the first glimpse of the efficacy or failure of a novel strategy to combat atherosclerosis. These findings suggest that vascular imaging could be employed to probe whether or not a large morbidity and mortality endpoint study should be the next step in a clinical development program.
动脉壁成像可产生经过验证的替代标志物,这些标志物能够为新型心血管药物的疗效提供早期指示。本文旨在探讨将动脉粥样硬化成像作为一种基准工具,以便在评估新型治疗策略时,做出是否开展大规模发病率和死亡率研究的明智决策。
动脉壁成像可用于评估个体心血管风险,并且相对于传统风险评分具有附加价值,因为它直接针对疾病过程。在对照临床试验中,血管成像表明,在高风险和低风险人群中均可评估脂质调节药物治疗的疗效,且这些结果与采用类似干预措施的临床研究结果相似。
动脉成像可能会让人初步了解对抗动脉粥样硬化新策略的疗效或失败情况。这些发现表明,血管成像可用于探究在临床开发计划中,是否应开展大规模发病率和死亡率终点研究。