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小剂量瑞舒伐他汀可改善血脂异常高危日本原发性预防人群的动脉僵硬度。

Low-dose rosuvastatin improves arterial stiffness in high-risk Japanese patients with dyslipdemia in a primary prevention group.

机构信息

Department of Cardiovascular Medicine, Shinshu University School of Health Sciences, Japan.

出版信息

Circ J. 2011;75(11):2660-7. doi: 10.1253/circj.cj-11-0497. Epub 2011 Aug 20.

Abstract

BACKGROUND

The treatment effects of rosuvastatin on arterial stiffness were assessed and compared to those of fluvastatin in high-risk Japanese patients with dyslipidemia in a primary prevention group.

METHODS AND RESULTS

Patients were randomly assigned to either 2.5-5 mg/day of rosuvastatin (Group A) or 20-40 mg/day of fluvastatin (Group B) and followed up for 12 months. In Group A (n=38), there was a progressive reduction in brachial-ankle pulse wave velocity (baPWV) along with a decrease in the low-density lipoprotein cholesterol/high-density lipoprotein cholesterol (L/H) ratio and high-sensitivity C-reactive protein (hsCRP), and the change in baPWV correlated significantly with that of the L/H ratio and that of hsCRP after rosuvastatin treatment. In Group B (n=37), although fluvastatin achieved a significant improvement in baPWV, L/H ratio, and hsCRP, baPWV was significantly greater than that in Group A and showed a significant correlation with that of hsCRP alone after fluvastatin treatment. In a subgroup of patients (n=26), switching from fluvastatin to rosuvastatin further improved baPWV and the L/H ratio without altering hsCRP after 12 months.

CONCLUSIONS

Low-dose rosuvastatin would be more effective than fluvastatin in improving arterial stiffness in high-risk Japanese patients with dyslipidemia. The results suggest that improvement in arterial stiffness by rosuvastatin mainly depends on its strong lipid-lowering effects, whereas that by fluvastatin is strongly dependent on the pleiotropic effects, especially an anti-inflammatory action.

摘要

背景

在血脂异常的高危日本患者一级预防人群中,评估了瑞舒伐他汀对动脉僵硬的治疗效果,并与氟伐他汀进行了比较。

方法和结果

患者被随机分配至每天 2.5-5mg 的瑞舒伐他汀(A 组)或每天 20-40mg 的氟伐他汀(B 组),并随访 12 个月。在 A 组(n=38)中,随着低密度脂蛋白胆固醇/高密度脂蛋白胆固醇(L/H)比值和高敏 C 反应蛋白(hsCRP)的降低,肱踝脉搏波速度(baPWV)逐渐降低,瑞舒伐他汀治疗后 baPWV 的变化与 L/H 比值和 hsCRP 的变化显著相关。在 B 组(n=37)中,虽然氟伐他汀可显著改善 baPWV、L/H 比值和 hsCRP,但 baPWV 仍显著高于 A 组,且氟伐他汀治疗后仅与 hsCRP 显著相关。在亚组患者(n=26)中,在转换为瑞舒伐他汀治疗 12 个月后,baPWV 和 L/H 比值进一步改善,而 hsCRP 没有改变。

结论

在血脂异常的高危日本患者中,小剂量瑞舒伐他汀比氟伐他汀更能有效改善动脉僵硬。结果表明,瑞舒伐他汀改善动脉僵硬主要依赖于其强大的降脂作用,而氟伐他汀则强烈依赖于其多效性作用,特别是抗炎作用。

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