Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
Am J Cardiol. 2019 May 15;123(10):1559-1564. doi: 10.1016/j.amjcard.2019.02.020. Epub 2019 Feb 22.
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.
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。