Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, Japan.
EuroIntervention. 2019 Dec 20;15(12):e1099-e1106. doi: 10.4244/EIJ-D-18-01073.
We aimed to assess the effect of 10 mg/day of rosuvastatin plus eicosapentaenoic acid (EPA) versus 2.5 mg/day of rosuvastatin on the extent of neoatherosclerosis using optical coherence tomography (OCT).
We randomly assigned 50 patients with non-obstructive neoatherosclerotic plaques detected on OCT to receive either rosuvastatin 10 mg/day and EPA 1,800 mg/day (intensive therapy group) or rosuvastatin 2.5 mg (standard therapy group). Follow-up OCT was performed one year later to evaluate serial changes in neoatherosclerosis. The serum low-density lipoprotein cholesterol (LDL-C) level decreased significantly from baseline to 12-month follow-up in the intensive therapy group (89 mg/dL to 70 mg/dL; p<0.001), while no change occurred in the standard therapy group. Lipid index change and percent changes in macrophage grade were significantly lower in the intensive therapy group than in the standard therapy group (-53.6 vs 310.1, p=0.001; -37.0% vs 35.3%, p<0.001; respectively). Percent changes in lipid index and macrophage grade were positively correlated with the changes in serum LDL-C and C-reactive protein levels, and negatively correlated with the change in serum EPA/arachidonic acid and 18-hydroxyeicosapentaenoic acid (EPA bioactive metabolite) level.
Compared with rosuvastatin 2.5 mg/day, rosuvastatin 10 mg/day and EPA 1,800 mg/day significantly stabilised non-obstructive neoatherosclerotic plaques.
UMIN ID: UMIN000012576. https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000014711.
我们旨在使用光学相干断层扫描（OCT）评估每天 10 毫克瑞舒伐他汀加二十碳五烯酸（EPA）与每天 2.5 毫克瑞舒伐他汀对新动脉粥样硬化程度的影响。
我们随机分配 50 名经 OCT 检测到非阻塞性新动脉粥样硬化斑块的患者，分别接受瑞舒伐他汀 10 毫克/天和 EPA 1800 毫克/天（强化治疗组）或瑞舒伐他汀 2.5 毫克（标准治疗组）治疗。一年后进行随访 OCT，以评估新动脉粥样硬化的连续变化。强化治疗组的血清低密度脂蛋白胆固醇（LDL-C）水平从基线到 12 个月随访时显著降低（89 毫克/分升降至 70 毫克/分升；p<0.001），而标准治疗组无变化。强化治疗组的脂质指数变化和巨噬细胞分级的百分比变化明显低于标准治疗组（-53.6 对 310.1，p=0.001；-37.0%对 35.3%，p<0.001；分别）。脂质指数和巨噬细胞分级的百分比变化与血清 LDL-C 和 C 反应蛋白水平的变化呈正相关，与血清 EPA/花生四烯酸和 18-羟基二十碳五烯酸（EPA 生物活性代谢物）水平的变化呈负相关。
与每天 2.5 毫克瑞舒伐他汀相比，每天 10 毫克瑞舒伐他汀和 1800 毫克 EPA 显著稳定了非阻塞性新动脉粥样硬化斑块。
UMIN ID：UMIN000012576。https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000014711。
