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急性心肌梗死发病前使用他汀类药物对罪犯病变冠状动脉斑块形态的影响。

Impact of statin use before the onset of acute myocardial infarction on coronary plaque morphology of the culprit lesion.

机构信息

Cardiovascular Center, Yokosuka Kyosai Hospital, Yokosuka, Kanagawa, Japan.

出版信息

Angiology. 2013 Jul;64(5):375-8. doi: 10.1177/0003319712449196. Epub 2012 Jun 7.

Abstract

Statins favorably stabilize coronary plaque. We evaluated the impact of statin use before the onset of acute myocardial infarction (AMI) on culprit lesion plaque morphology. Patients (n = 127) with AMI were divided into either a statin group (n = 31) or a nonstatin group (n = 96) based on statin use before the onset of AMI. Coronary plaque morphology of the culprit lesion was evaluated using intravascular ultrasound virtual histology (IVUS-VH) with radiofrequency data analysis before coronary intervention. The IVUS-VH identified 4 types of plaque components: fibrous, fibrofatty, dense calcium, and necrotic core. The IVUS-VH showed less percentage of necrotic area, greater percentage fibrous area, and greater percentage of fibrofatty area of the culprit lesion in the statin group. In conclusion, statin use before the onset of AMI might have effects on coronary plaque morphology of the AMI culprit lesion with less necrotic core and greater fibrous and fibrofatty component.

摘要

他汀类药物能稳定冠状动脉斑块。我们评估了急性心肌梗死(AMI)发作前使用他汀类药物对罪犯病变斑块形态的影响。根据 AMI 发作前是否使用他汀类药物,将 127 例 AMI 患者分为他汀类药物组(n=31)和非他汀类药物组(n=96)。在冠状动脉介入治疗前,采用血管内超声虚拟组织学(IVUS-VH)和射频数据分析对罪犯病变的冠状动脉斑块形态进行评估。IVUS-VH 可识别出 4 种斑块成分:纤维、纤维脂肪、致密钙和坏死核心。他汀类药物组罪犯病变的坏死面积百分比较小,纤维面积百分比较大,纤维脂肪面积百分比较大。总之,AMI 发作前使用他汀类药物可能会影响 AMI 罪犯病变的冠状动脉斑块形态,使坏死核心更小,纤维和纤维脂肪成分更多。

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