First Department of Internal Medicine, Nara Medical University.
Circ J. 2011;75(11):2621-7. doi: 10.1253/circj.cj-11-0139. Epub 2011 Aug 6.
Clinical studies using invasive modalities have reported that statin therapy stabilizes coronary plaque vulnerability. The serial changes of lipid-rich coronary plaques (LRCPs) during rosuvastatin treatment were evaluated non-invasively in patients with acute coronary syndrome (ACS) using dual-source computed tomography (DSCT).
A total of 11 consecutive ACS patients, and 13 LRCPs were serially evaluated on DSCT before and 24 weeks after rosuvastatin treatment. Compared with the baseline, there was no change in post-treatment minimal lumen diameter, lumen volume, or longitudinal length of LRCPs. By contrast, the ratio of lipid core volume to plaque volume significantly decreased from 48.0 ± 9.9% to 43.7 ± 10.6% (P=0.04), and plaque volume decreased from 144.5 ± 85.5 mm³ to 119.8 ± 78.0 mm³ (P=0.07). The remodeling index of target LRCPs significantly decreased from 1.16 ± 0.10 to 1.06 ± 0.12 (P=0.02). Percent reduction of plaque volume was significantly greater in patients with a lower ratio of low-density lipoprotein to high-density lipoprotein (L/H ratio ≤ 1.5) at follow-up than patients with higher L/H ratio (>1.5; median -31.7% vs. -6.8%, P=0.03).
Rosuvastatin therapy reduced the volume of lipid cores and LRCPs and increased the CT attenuation value of LRCPs. DSCT is an effective modality for the non-invasive evaluation of LRCPs in patients with ACS. ).
使用有创手段的临床研究报告称，他汀类药物治疗稳定了冠状动脉斑块的脆弱性。使用双源 CT（DSCT）对急性冠状动脉综合征（ACS）患者进行非侵入性评估，评估瑞舒伐他汀治疗期间富含脂质的冠状动脉斑块（LRCP）的连续变化。
共连续评估了 11 例 ACS 患者的 13 个 LRCPs，在瑞舒伐他汀治疗前和治疗后 24 周在 DSCT 上进行评估。与基线相比，治疗后最小管腔直径、管腔体积或 LRCP 的纵向长度没有变化。相比之下，脂质核心体积与斑块体积的比值从 48.0±9.9%显著降低至 43.7±10.6%（P=0.04），斑块体积从 144.5±85.5mm³降低至 119.8±78.0mm³（P=0.07）。目标 LRCP 的重塑指数从 1.16±0.10 显著降低至 1.06±0.12（P=0.02）。在随访时，L/H 比值较低（≤1.5）的患者与 L/H 比值较高（>1.5）的患者相比，斑块体积的百分比降低更明显（中位数-31.7%与-6.8%，P=0.03）。
瑞舒伐他汀治疗降低了脂质核心和 LRCP 的体积，并增加了 LRCP 的 CT 衰减值。DSCT 是评估 ACS 患者 LRCP 的有效非侵入性方法。
