Niki Toshiyuki, Wakatsuki Tetsuzo, Yamaguchi Koji, Taketani Yoshio, Oeduka Hiroyasu, Kusunose Kenya, Ise Takayuki, Iwase Takashi, Yamada Hirotsugu, Soeki Takeshi, Sata Masataka
Division of Cardiovascular Medicine, Tokushima University Hospital.
Circ J. 2016;80(2):450-60. doi: 10.1253/circj.CJ-15-0813. Epub 2015 Dec 11.
The effects of eicosapentaenoic acid (EPA) on coronary artery disease have been previously reported; however, those of the addition of EPA to strong statins on coronary plaque components and local inflammatory cytokines are not known.
A total of 95 patients who had been treated with strong statin for at least 6 months were randomized into 2 groups: an EPA group (additional treatment with EPA at 1,800 mg/day, n=48) or a control group (no additional treatment, n=47), for 6 months. The tissue characteristics of target coronary plaque in each patient were analyzed using IB-IVUS before and after treatment. We also measured plasma levels of inflammatory cytokines sampled in the coronary sinus (CS) and peripheral vein.A significant reduction in lipid volume (18.5 ± 1.3 to 15.0 ± 1.5 mm(3), P=0.007) and a significant increase in fibrous volume (22.9 ± 0.8 to 25.6 ± 1.1 mm(3), P=0.01) were observed in IB-IVUS image analyses in the EPA group, but no significant changes in the plaque components in the control group. CS levels of pentraxin 3 and monocyte chemoattractant protein-1 were lower after than before treatment with EPA (3.3 ± 2.1 to 2.6 ± 1.2 ng/ml, 120.4 ± 26.2 to 110.2 ± 26.8 pg/ml, P=0.015 and P=0.008, respectively); however, there were no significant changes in those inflammatory cytokines between pre- and post-treatment in the control group.
The addition of EPA was associated with reduced lipid volume in coronary plaques and decreased inflammatory cytokines.
此前已有关于二十碳五烯酸（EPA）对冠状动脉疾病影响的报道；然而，在强效他汀类药物基础上加用EPA对冠状动脉斑块成分及局部炎症细胞因子的影响尚不清楚。
将95例接受强效他汀治疗至少6个月的患者随机分为2组：EPA组（加用EPA 1800毫克/天进行额外治疗，n = 48）和对照组（不进行额外治疗，n = 47），为期6个月。在治疗前后使用血管内超声（IVUS）对每位患者的目标冠状动脉斑块的组织特征进行分析。我们还测量了从冠状窦（CS）和外周静脉采集的炎症细胞因子的血浆水平。在EPA组的血管内超声图像分析中观察到脂质体积显著减少（从18.5±1.3立方毫米降至15.0±1.5立方毫米，P = 0.007），纤维体积显著增加（从22.9±0.8立方毫米增至25.6±1.1立方毫米，P = 0.01），而对照组的斑块成分无显著变化。EPA治疗后，CS中五聚体3和单核细胞趋化蛋白 - 1的水平低于治疗前（分别为3.3±2.1至2.6±1.2纳克/毫升，120.4±26.2至110.2±26.8皮克/毫升，P = 0.015和P = 0.008）；然而，对照组治疗前后这些炎症细胞因子无显著变化。
加用EPA与冠状动脉斑块脂质体积减少及炎症细胞因子降低有关。
