Department of Cardiology, Odense University Hospital, Odense, Denmark.
EuroIntervention. 2013 Feb 22;8(10):1182-9. doi: 10.4244/EIJV8I10A182.
The aim of this study was to evaluate the effect of low-dose versus high-dose rosuvastatin therapy on the necrotic core (NC) content in coronary plaques of angiographic non-significant lesions as assessed by intravascular ultrasound - virtual histology.
Eighty-seven statin-naive patients with ST-segment elevation myocardial infarction (STEMI) were randomised to 5 mg or 40 mg rosuvastatin. The volume of each plaque component (necrotic core, fibrous tissue, fibro-fatty, and dense calcium) was assessed at baseline and after 12 months of follow-up. Baseline low-density lipoprotein (LDL) cholesterol level was reduced by 31.8% in the low-dose group (from 3.1±0.7 mmol/l to 2.0±0.4 mmol/l, p<0.001) vs. 49.0% in the high-dose group (from 3.1±1.0 mmol/l to 1.6±0.7 mmol/l, p<0.001) (p=0.001 between groups). The plaque component necrotic core was reduced by 7.6% in the low-dose group (44.6±38.2 mm3 vs. 41.2±40.3 mm3, p=0.29) compared to 14.2% in the high-dose group (47.4±38.2 mm3 vs. 40.7±34.4 mm3, p=0.003) (p=0.38 between groups).
In statin-naive patients with STEMI, rosuvastatin therapy for 12 months resulted in significant reduction in LDL-cholesterol; however, a significant decrease in necrotic core volume was only seen in the high-dose group.
本研究旨在评估低剂量与高剂量瑞舒伐他汀治疗对血管内超声虚拟组织学评估的非显著病变冠状动脉斑块内坏死核心（NC）含量的影响。
87 例他汀类药物初治的 ST 段抬高型心肌梗死（STEMI）患者被随机分为 5mg 或 40mg 瑞舒伐他汀组。在基线和 12 个月随访时评估每个斑块成分（坏死核心、纤维组织、纤维脂肪和致密钙）的体积。低剂量组的低密度脂蛋白（LDL）胆固醇水平从基线时的 3.1±0.7mmol/l 降低至治疗 12 个月时的 2.0±0.4mmol/l（p<0.001），降幅为 31.8%；而高剂量组从 3.1±1.0mmol/l 降低至治疗 12 个月时的 1.6±0.7mmol/l（p<0.001），降幅为 49.0%（两组间比较，p=0.001）。低剂量组的斑块成分坏死核心体积从 44.6±38.2mm3 降低至 41.2±40.3mm3（p=0.29），降幅为 7.6%；而高剂量组从 47.4±38.2mm3 降低至 40.7±34.4mm3（p=0.003），降幅为 14.2%（两组间比较，p=0.38）。
在他汀类药物初治的 STEMI 患者中，瑞舒伐他汀治疗 12 个月可显著降低 LDL-胆固醇；然而，只有高剂量组的坏死核心体积才显著减小。
