Department of Medicine, Uppsala University Hospital, Heidelberglaan 100, Uppsala, Sweden.
J Am Soc Echocardiogr. 2012 Oct;25(10):1120-1127.e1. doi: 10.1016/j.echo.2012.07.004. Epub 2012 Aug 9.
The echolucency of the carotid intima-media is related to increased cardiovascular risk factor levels, morbidity, and mortality. The aim of this study was to assess the effect of statins on the echolucency of the common carotid intima-media in a low-risk population.
Data from the Measuring Effects on Intima-Media Thickness: An Evaluation of Rosuvastatin study were used. Ultrasound images from the far walls of the left and right common carotid arteries were used for evaluation of the echolucency of the carotid intima-media, measured by grayscale median (GSM). Low GSM values reflect echolucent structures, whereas high values reflect echogenic structures. The primary end point was the difference in the annual rate of change in GSM between rosuvastatin and placebo.
Two-year change in GSM did not significantly differ between rosuvastatin and placebo in the total population, with a mean difference in the rate of change in GSM of 1.13 (95% confidence interval, -1.00 to 3.25). The effect of rosuvastatin differed across quintiles of baseline GSM values (P for interaction = .01). In the lowest quintile (n = 175) (i.e., in those with the most echolucent intima-media), the difference in the rate of change in GSM between rosuvastatin and placebo was 4.18 (95% confidence interval, -0.23 to 8.58). Increases in GSM were significantly related to decreasing low-density lipoprotein cholesterol levels in the lowest quintile (β = 0.76; 95% confidence interval, 0.26 to 1.25).
Treatment with rosuvastatin did not affect the echolucency of the arterial wall in all low-risk individuals. However, a potential effect of rosuvastatin on the echolucency of the common carotid intima-media is most likely to be found in individuals with echolucent arterial walls at baseline.
颈动脉内膜中层的回声与其心血管风险因素水平、发病率和死亡率的增加有关。本研究的目的是评估他汀类药物对低危人群颈总动脉内膜中层回声的影响。
本研究使用了来自Measuring Effects on Intima-Media Thickness: An Evaluation of Rosuvastatin 研究的数据。使用左、右颈总动脉远壁的超声图像来评估颈动脉内膜中层的回声，通过灰度中位数（GSM）进行测量。低 GSM 值反映回声较暗的结构，而高 GSM 值反映回声较强的结构。主要终点是 rosuvastatin 和安慰剂之间 GSM 年变化率的差异。
在总人群中，rosuvastatin 和安慰剂治疗 2 年后，GSM 的变化差异无统计学意义，GSM 变化率的平均差异为 1.13（95%置信区间，-1.00 至 3.25）。rosuvastatin 的作用在基线 GSM 值五分位数之间存在差异（P 交互效应=.01）。在最低五分位数（n=175）（即回声最亮的内膜-中层）中，rosuvastatin 和安慰剂之间 GSM 变化率的差异为 4.18（95%置信区间，-0.23 至 8.58）。在最低五分位数中，GSM 的增加与 LDL 胆固醇水平的降低显著相关（β=0.76；95%置信区间，0.26 至 1.25）。
rosuvastatin 治疗并未影响所有低危个体的动脉壁回声。然而，rosuvastatin 对颈总动脉内膜中层回声的潜在影响最有可能在基线时动脉壁回声较亮的个体中发现。
