Department of Cardiology, Hokkaido Cardiovascular Hospital, Sapporo, Japan.
Department of Cancer Pathology, Hokkaido University Faculty of Medicine, Sapporo, Japan.
Clin Cardiol. 2019 Jun;42(6):618-628. doi: 10.1002/clc.23185. Epub 2019 Apr 23.
The relationship between eicosapentaenoic acid (EPA) therapy and coronary plaque stability assessed by optical frequency domain imaging (OFDI) has not been thoroughly described.
EPA therapy is associated with decreased plaque instability in patients undergoing percutaneous coronary intervention (PCI) using OFDI.
Data on coronary artery plaques from 121 patients who consecutively underwent PCI between October 2015 and July 2018 were retrospectively analyzed. Of these patients, 109 were untreated (no-EPA group), whereas 12 were treated with EPA (EPA group). Each plaque's morphological characteristics were analyzed using OFDI.
We used 1:4 propensity score matching for patients who received or did not receive EPA therapy before PCI. Baseline characteristics were balanced between both groups (age, sex, body mass index, diabetes mellitus, hypertension, dyslipidemia, chronic kidney disease, smoking, previous PCI or coronary artery bypass grafting, previous myocardial infarction, prior statin use, acute coronary syndrome, hemoglobin A1c level, low-density lipoprotein cholesterol concentration, triglyceride concentration, and high-density lipoprotein cholesterol concentration). OFDI data from 60 patients were analyzed in this study. The EPA group had significantly lower mean lipid index (818 ± 806 vs 1574 ± 891) and macrophage grade (13.5 ± 5.9 vs 19.3 ± 7.4) but higher mean minimum fibrous cap thickness (109.2 ± 55.7 vs 81.6 ± 36.4 μm) than the no-EPA group (P = 0.010, 0.019, and 0.040, respectively). Multiple logistic regression analyses showed that prior EPA use was independently associated with lower lipid index and macrophage grade (P = 0.043 and 0.024, respectively).
This OFDI analysis suggests that EPA therapy is associated with decreased plaque instability in patients undergoing PCI.
通过光频域成像（OFDI）评估，二十碳五烯酸（EPA）治疗与冠状动脉斑块稳定性之间的关系尚未得到充分描述。
在接受经皮冠状动脉介入治疗（PCI）的患者中，EPA 治疗与斑块不稳定程度降低有关。
回顾性分析了 2015 年 10 月至 2018 年 7 月期间连续接受 PCI 的 121 例患者的冠状动脉斑块数据。其中 109 例未接受治疗（无-EPA 组），12 例接受 EPA 治疗（EPA 组）。使用 OFDI 分析每个斑块的形态特征。
我们对接受或未接受 EPA 治疗的患者进行了 1:4 的倾向评分匹配。两组患者的基线特征平衡（年龄、性别、体重指数、糖尿病、高血压、血脂异常、慢性肾脏病、吸烟、既往 PCI 或冠状动脉旁路移植术、既往心肌梗死、既往他汀类药物使用、急性冠状动脉综合征、糖化血红蛋白水平、低密度脂蛋白胆固醇浓度、甘油三酯浓度和高密度脂蛋白胆固醇浓度）。本研究分析了 60 例患者的 OFDI 数据。与无-EPA 组相比，EPA 组的平均脂质指数（818±806 与 1574±891）和巨噬细胞分级（13.5±5.9 与 19.3±7.4）显著降低，但平均最小纤维帽厚度（109.2±55.7 与 81.6±36.4μm）更高（P=0.010、0.019 和 0.040）。多因素逻辑回归分析显示，既往 EPA 使用与脂质指数和巨噬细胞分级降低独立相关（P=0.043 和 0.024）。
这项 OFDI 分析表明，在接受 PCI 的患者中，EPA 治疗与斑块不稳定性降低有关。
