Oh Minyoung, Lee Cheol Whan, Ahn Jung-Min, Park Duk-Woo, Kang Soo-Jin, Lee Seung-Whan, Kim Young-Hak, Moon Dae Hyuk, Park Seong-Wook, Park Seung-Jung
Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
Department of Medicine, University of Ulsan College of Medicine, Seoul, South Korea.
Clin Cardiol. 2019 Feb;42(2):241-246. doi: 10.1002/clc.23133. Epub 2018 Dec 20.
The renin-angiotensin system plays an important role in promoting atherosclerotic plaque inflammation, which may be inhibited by angiotension-II receptor blockers.
We investigated the effects of fimasartan and amlodipine therapy on carotid atherosclerotic plaque inflammation using F-fluorodeoxyglucose ( FDG) positron emission tomography (PET) imaging.
Fifty patients with acute coronary syndrome (ACS) and at least one lesion with FDG uptake in the carotid artery (target-to-background ratio [TBR] ≥ 1.6) were randomly assigned to receive either fimasartan (60 mg once a day) or amlodipine (5 mg once a day). FDG PET examinations were performed in all patients at baseline and 6 months. The primary endpoint was the percent change in the index vessel TBR for the most diseased segment (MDS TBR).
The two groups had similar baseline characteristics. At the 6-month follow-up, index vessel and aorta MDS TBR significantly decreased in both groups. However, the percent change in index vessel MDS TBR was similar between the two groups (-9.33 ± 14.2% vs -7.73 ± 19.1%, respectively, P = 0.9). No significant difference was found for the percent change in the whole vessel TBR for the index vessel between the two groups, with similar findings for changes in MDS TBR or whole vessel TBR for the aorta. Total cholesterol, low-density lipoprotein cholesterol levels, and blood pressure improved to a similar degree in both groups.
Fimasartan and amlodipine reduce carotid atherosclerotic plaque inflammation similarly in patients with ACS, offering the same level of effectiveness.
肾素-血管紧张素系统在促进动脉粥样硬化斑块炎症方面起重要作用，血管紧张素II受体阻滞剂可能会抑制这种作用。
我们使用18F-氟脱氧葡萄糖（18F-FDG）正电子发射断层扫描（PET）成像研究了非马沙坦和氨氯地平治疗对颈动脉粥样硬化斑块炎症的影响。
50例急性冠状动脉综合征（ACS）患者且至少有一个颈动脉病变伴有18F-FDG摄取（靶本比[TBR]≥1.6）被随机分配接受非马沙坦（每日一次60毫克）或氨氯地平（每日一次5毫克）治疗。所有患者在基线和6个月时进行18F-FDG PET检查。主要终点是最病变节段的指数血管TBR的变化百分比（MDS TBR）。
两组基线特征相似。在6个月随访时，两组的指数血管和主动脉MDS TBR均显著降低。然而，两组之间指数血管MDS TBR的变化百分比相似（分别为-9.33±14.2%和-7.73±19.1%，P = 0.9）。两组之间指数血管的全血管TBR变化百分比无显著差异，主动脉的MDS TBR或全血管TBR变化情况相似。两组的总胆固醇、低密度脂蛋白胆固醇水平和血压改善程度相似。
在ACS患者中，非马沙坦和氨氯地平对颈动脉粥样硬化斑块炎症的减轻作用相似，有效性相当。
