Zhu Yinchun, Lin Lin, Wang Chao, Jia Haibo, Hu Sining, Li Lulu, Zhang Xiling, Zheng Gonghui, Wang Yan, Sun Rong, Afolabi Abigail, Mustafina Irina, Hou Jingbo, Zhang Shaosong, Yu Bo
Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, The Key Laboratory of Myocardial Ischemia, Chinese Ministry of Education, Harbin, China.
Department of Cardiology, The Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Oncotarget. 2017 Apr 18;8(16):27401-27411. doi: 10.18632/oncotarget.16172.
The aim of the study was to investigate the impact of statins therapy on morphological changes of lipid-rich plaques by OCT (optical coherence tomography) in patients with known CHD (coronary heart disease), stratified by FRS. Ninety-seven lipid-rich plaques from sixty-nine patients who received statins therapy and underwent serial OCT images (baseline, 6-month and 12-month) were divided into 2 groups according to the FRS (framingham risk score): low risk group A (FRS<10%, N=35, n=45), moderate to high risk group B (FRS≥10%, N=34, n=52). Fibrous cap thickness (FCT) was measured at its thinnest part 3 times. Baseline characteristics were not different between the 2 groups. FCT sustained increased from baseline to 6-month and 12-month follow up in both group A (59.8±20.4μm, 118.3±62.5μm, and 158.8±83.4μm respectively, P<0.001) and group B (62.2±16.8μm, 125.1±78.7μm, 163.8±75.5μm respectively, P<0.001). Lipid index was significantly decreased in both group A (1862.1±1164.5, 1530.3±1108.7, 1322.9±1080.4, P<0.001) and group B (1646.6±958.5, 1535.1±1049.1, 1258.6±1045, P=0.016). The incidence of TCFA was decreased statistically in both group A (P <0.001) and group B (P <0.001). The patients with known CHD can equivalently benefit from statins therapy by stabilizing the lipid-rich plaques. Patients with moderate to high FRS might benefit more within the first year from event time.
本研究旨在通过光学相干断层扫描(OCT)研究他汀类药物治疗对已知冠心病(CHD)患者富含脂质斑块形态学变化的影响,并根据弗雷明汉风险评分(FRS)进行分层。对69例接受他汀类药物治疗并接受系列OCT图像检查(基线、6个月和12个月)患者的97个富含脂质斑块,根据FRS分为2组:低风险A组(FRS<10%,N=35,n=45),中度至高度风险B组(FRS≥10%,N=34,n=52)。在纤维帽最薄处测量3次纤维帽厚度(FCT)。两组间基线特征无差异。A组(分别为59.8±20.4μm、118.3±62.5μm和158.8±83.4μm,P<0.001)和B组(分别为62.2±16.8μm、125.1±78.7μm、163.8±75.5μm,P<0.001)从基线到6个月和12个月随访时FCT均持续增加。A组(1862.1±1164.5、1530.3±1108.7、1322.9±1080.4,P<0.001)和B组(1646.6±958.5、1535.1±1049.1、1258.6±1045,P=0.016)的脂质指数均显著降低。两组A组(P<0.001)和B组(P<0.001)中罪犯型冠状动脉粥样硬化(TCFA)的发生率均有统计学意义的降低。已知冠心病患者通过稳定富含脂质的斑块可等效地从他汀类药物治疗中获益。FRS中度至高度的患者在事件发生后的第一年可能获益更多。