有或无栓塞事件患者主动脉粥样硬化的短期演变（9个月）：一项经食管超声心动图随访研究
Short-term evolution (9 months) of aortic atheroma in patients with or without embolic events: a follow-up transoesophageal echocardiographic study.
作者信息
De Castro Stefano, Di Angelantonio Emanuele, Celotto Annalisa, Fiorelli Marco, Passaseo Ilaria, Papetti Federica, Caselli Stefano, Marcantonio Andrea, Cohen Ariel, Pandian Natesa
机构信息
Department of Cardiovascular, Respiratory and Morphological Sciences, University of Rome La Sapienza, Policlinico Umberto I degrees, Viale del Policlinico, 155, 00161 Rome, Italy.
出版信息
Eur J Echocardiogr. 2009 Jan;10(1):96-102. doi: 10.1093/ejechocard/jen172. Epub 2008 May 30.
AIMS
The influence of clinical risk factors and therapeutic options on aortic plaque changes is unknown. In this study, we have evaluated aortic atheroma (AA) evolution in patients with and without embolic events.
METHODS AND RESULTS
We enrolled 83 patients (mean age 67.9+/-8.6 years). All patients were studied with transoesophageal echocardiography at baseline and 9 months after enrolment. Baseline atherosclerotic plaques were defined as uncomplicated (between 1 and 3.9 mm) and complicated aortic plaques (>or=4 mm). To minimize sub-millimetre errors in plaque evolution, AA progression was defined as an increase in maximal plaque thickness>or=1 mm. Similarly, regression was defined as a decrease in maximal thickness of atheromatous plaque>or=1 mm. Aortic plaques were classified as uncomplicated in 20.5% and complicated in 79.5% of patients. Fifty-five plaques (47.8%), both complicated and uncomplicated, remained unchanged. Conversely, 16 plaques (13.9%) increased (mean plaque thickness from 3.94+/-1.39 to 5.56+/-1.41 mm, P<0.001) and 44 (38.3%) decreased (mean plaque thickness from 5.25+/-1.52 to 3.79+/-1.53 mm, P<0.001). Multinomial logistic regression procedure suggests that statins increase the probability of plaque thickness reduction (OR 5.92, 95% CI 1.27-27.7, P=0.024) and decrease the probability of plaque progression (OR 0.03, 95% CI 0.01-0.28, P=0.002).
CONCLUSION
This study suggests that statins may reduce the risk of AA progression.
目的
临床风险因素和治疗选择对主动脉斑块变化的影响尚不清楚。在本研究中，我们评估了有和没有栓塞事件的患者的主动脉粥样硬化（AA）进展情况。
方法与结果
我们纳入了83例患者（平均年龄67.9±8.6岁）。所有患者在基线时和入组后9个月接受经食管超声心动图检查。基线动脉粥样硬化斑块被定义为非复杂斑块（1至3.9毫米之间）和复杂主动脉斑块（≥4毫米）。为了尽量减少斑块演变中的亚毫米误差，AA进展被定义为最大斑块厚度增加≥1毫米。同样，消退被定义为动脉粥样斑块最大厚度减少≥1毫米。20.5%的患者主动脉斑块被分类为非复杂斑块，79.5%为复杂斑块。55个斑块（47.8%），包括复杂斑块和非复杂斑块，保持不变。相反，16个斑块（13.9%）增大（平均斑块厚度从3.94±1.39毫米增加到5.56±1.41毫米，P<0.001），44个斑块（38.3%）减小（平均斑块厚度从5.25±1.52毫米减少到3.79±1.53毫米，P<0.001）。多项逻辑回归分析表明，他汀类药物增加斑块厚度降低的概率（比值比5.92，95%置信区间1.27 - 27.7，P = 0.024），并降低斑块进展的概率（比值比0.03，95%置信区间）。
结论
本研究表明他汀类药物可能降低AA进展的风险。
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