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比较有糖尿病与无糖尿病患者的他汀类药物治疗的血管反应。

Comparison of Vascular Response to Statin Therapy in Patients With Versus Without Diabetes Mellitus.

机构信息

Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.

Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.

出版信息

Am J Cardiol. 2019 May 15;123(10):1559-1564. doi: 10.1016/j.amjcard.2019.02.020. Epub 2019 Feb 22.

Abstract

Diabetes mellitus (DM) increases cardiovascular morbidity and mortality. A statin is routinely prescribed to patients with DM. However, whether a statin therapy is equally effective in plaque stabilization in DM patients compared with non-DM patients is unknown. A total of 117 lipid-rich plaques were imaged in 90 patients (54 plaques in 41 DM patients and 63 plaques in 49 non-DM patients) with coronary artery disease, those who were treated with a statin and underwent serial optical coherence tomography imaging were included in this study (mean follow-up period, 362 ± 38 days). The changes in minimum fibrous cap thickness (FCT) and lipid index between baseline and 1-year follow-up were compared between the 2 groups. Minimum FCT increased and lipid index decreased with statin therapy in both groups. No significant differences were observed in percent changes of minimum FCT (p = 0.796) and lipid index (p = 0.336) between DM and non-DM patients. Statin therapy induced a significant increase in FCT and a significant decrease in lipid index in both groups. Vascular response to statin therapy was similar between the 2 groups irrespective of DM status.

摘要

糖尿病(DM)增加心血管发病率和死亡率。常规向 DM 患者开具他汀类药物。然而,与非 DM 患者相比,他汀类药物治疗在斑块稳定方面是否对 DM 患者同样有效尚不清楚。这项研究共纳入了 90 例冠心病患者(41 例 DM 患者中有 54 个斑块,49 例非 DM 患者中有 63 个斑块)的 117 个富含脂质的斑块,这些患者接受了他汀类药物治疗,并接受了连续光学相干断层扫描成像。(平均随访时间为 362 ± 38 天)。比较了两组患者在基线和 1 年随访时最小纤维帽厚度(FCT)和脂质指数的变化。两组患者在他汀类药物治疗后最小 FCT 增加,脂质指数降低。两组患者最小 FCT 的百分比变化(p = 0.796)和脂质指数的百分比变化(p = 0.336)无显著差异。他汀类药物治疗在两组患者中均引起 FCT 的显著增加和脂质指数的显著降低。他汀类药物治疗的血管反应在两组之间相似,与 DM 状态无关。

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