Hongo Minoru, Tsutsui Hiroshi, Mawatari Eiichiro, Hidaka Hiroya, Kumazaki Setsuo, Yazaki Yoshikazu, Takahashi Masafumi, Kinoshita Osamu, Ikeda Uichi
Department of Cardiovascular Medicine, Shinshu University School of Health Sciences, Matsumoto, Japan.
Circ J. 2008 May;72(5):722-8. doi: 10.1253/circj.72.722.
The present study was designed to test the hypothesis that fluvastatin might improve arterial stiffness, as assessed with pulse wave velocity (PWV), in patients with coronary artery disease (CAD) and hyperlipidemia over the long term.
Ninety-three patients were randomly assigned to either fluvastatin (group A, n=50) or bezafibrate (group B, n=43) and followed for 5 years. There was no difference in the clinical findings between the 2 groups. In group A, there was a progressive reduction in the brachial-ankle PWV along with a decrease in serum low-density lipoprotein-cholesterol (LDL-C) and C-reactive protein (CRP) by 12 months after fluvastatin, and the improvement was maintained until 5 years after treatment. In group B, despite identical lowering of the serum lipid, PWV was progressively increased. In group A, the percentage change in PWV correlated significantly with that of the serum CRP (r=0.49, p<0.001), but not with that of the serum LDL-C after treatment.
The beneficial vascular effects of fluvastatin persisted for a long period in patients with CAD and hyperlipidemia. Its anti-inflammatory action might contribute to the favorable effects on arterial stiffness.
本研究旨在验证这样一个假设，即长期来看，氟伐他汀可能会改善冠心病（CAD）和高脂血症患者的动脉僵硬度，这一指标通过脉搏波速度（PWV）来评估。
93例患者被随机分为氟伐他汀组（A组，n = 50）或苯扎贝特组（B组，n = 43），并随访5年。两组的临床结果无差异。在A组，服用氟伐他汀12个月后，肱踝脉搏波速度逐渐降低，同时血清低密度脂蛋白胆固醇（LDL-C）和C反应蛋白（CRP）水平下降，且这种改善在治疗后5年一直维持。在B组，尽管血脂水平同样降低，但脉搏波速度却逐渐升高。在A组，脉搏波速度的百分比变化与血清CRP的变化显著相关（r = 0.49，p < 0.001），但与治疗后血清LDL-C的变化无关。
氟伐他汀对CAD和高脂血症患者的血管有益作用长期持续存在。其抗炎作用可能是对动脉僵硬度产生有利影响的原因。
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