Jung Lae-Young, Lee Sang-Rok, Jung Jin-Mu, Kim Yi-Shik, Lee Sun-Hwa, Rhee Kyoung-Suk, Chae Jei-Keon, Lee Dong-Hwan, Kim Dal-Sik, Kim Won-Ho, Ko Jae-Ki
Division of Cardiology, Chonbuk National University Hospital and Chonbuk National University Medical School, Jeonju, Korea.
Division of Mechanical Design Engineering, Chonbuk National University, Jeonju, Korea.
Korean Circ J. 2016 Mar;46(2):147-53. doi: 10.4070/kcj.2016.46.2.147. Epub 2016 Mar 21.
Wall shear stress contributes to atherosclerosis progression and plaque rupture. There are limited studies for statin as a major contributing factor on whole blood viscosity (WBV) in patients with acute coronary syndrome (ACS). This study investigates the effect of statin on WBV in ACS patients.
We prospectively enrolled 189 consecutive patients (mean age, 61.3±10.9 years; 132 males; ST-segment elevation myocardial infarction, n=52; non-ST-segment elevation myocardial infarction, n=84; unstable angina n=53). Patients were divided into two groups (group I: previous use of statins for at least 3 months, n=51; group II: statin-naïve patients, n=138). Blood viscosities at shear rates of 1 s-1 (diastolic blood viscosity; DBV) and 300 s-1 (systolic blood viscosity; SBV) were measured at baseline and one month after statin treatment. Rosuvastatin was administered to patients after enrollment (mean daily dose, 16.2±4.9 mg).
Baseline WBV was significantly higher in group II ([SBV: group I vs group II, 40.8±5.9 mP vs. 44.2±7.4 mP, p=0.003], [DBV: 262.2±67.8 mP vs. 296.9±76.0 mP, p=0.002]). WBV in group II was significantly lower one month after statin treatment ([SBV: 42.0±4.7 mP, p=0.012, DBV: 281.4±52.6 mP, p=0.044]). However, low-density lipoprotein cholesterol level was not associated with WBV in both baseline (SBV: R2=0.074, p=0.326; DBV: R2=0.073, p=0.337) and after one month follow up (SBV: R2=0.104, p=0.265; DBV: R2=0.112, p=0.232).
Previous statin medication is an important determinant in lowering WBV in patients with ACS. However, one month of rosuvastatin decreased WBV in statin-naïve ACS patients.
血管壁剪切应力会促进动脉粥样硬化进展和斑块破裂。关于他汀类药物作为急性冠状动脉综合征(ACS)患者全血粘度(WBV)主要影响因素的研究有限。本研究旨在探讨他汀类药物对ACS患者WBV的影响。
我们前瞻性纳入了189例连续患者(平均年龄61.3±10.9岁;男性132例;ST段抬高型心肌梗死52例;非ST段抬高型心肌梗死84例;不稳定型心绞痛53例)。患者分为两组(I组:既往使用他汀类药物至少3个月,51例;II组:未使用过他汀类药物的患者,138例)。在基线和他汀类药物治疗1个月后,测量剪切速率为1 s-1时的血液粘度(舒张压血液粘度;DBV)和300 s-1时的血液粘度(收缩压血液粘度;SBV)。入选患者给予瑞舒伐他汀治疗(平均日剂量16.2±4.9 mg)。
II组基线WBV显著更高([SBV:I组 vs II组,40.8±5.9 mP 对 44.2±7.4 mP,p = 0.003],[DBV:262.2±67.8 mP 对 296.9±76.0 mP,p = 0.002])。他汀类药物治疗1个月后,II组的WBV显著降低([SBV:42.0±4.7 mP,p = 0.012,DBV:281.4±52.6 mP,p = 0.044])。然而,低密度脂蛋白胆固醇水平在基线时(SBV:R2 = 0.074,p = 0.326;DBV:R2 = 0.073,p = 0.337)和随访1个月后(SBV:R2 = 0.104,p = 0.265;DBV:R2 = 0.112,p = 0.232)均与WBV无关。
既往使用他汀类药物是降低ACS患者WBV的重要决定因素。然而,1个月的瑞舒伐他汀治疗可降低未使用过他汀类药物的ACS患者的WBV。