Department of Nuclear Medicine.
Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Medicine (Baltimore). 2021 Mar 12;100(10):e25114. doi: 10.1097/MD.0000000000025114.
It remains uncertain whether statin/ezetimibe combination therapy serves as a useful and equivalent alternative to statin monotherapy for reducing atherosclerotic plaque inflammation. The aim of the present study was to compare the effects of statin/ezetimibe combination therapy and statin monotherapy on carotid atherosclerotic plaque inflammation using 18F-fluorodeoxyglucose (18FDG) positron emission tomography (PET)/computed tomography (CT) imaging. Data were pooled from 2 clinical trials that used serial 18FDG PET/CT examination to investigate the effects of cholesterol-lowering therapy on carotid atherosclerotic plaque inflammation. The primary outcome was the percent change in the target-to-background ratio (TBR) of the index vessel in the most diseased segment (MDS) at 6-month follow-up. Baseline characteristics were largely similar between the 2 groups. At the 6-month follow-up, the MDS TBR of the index vessel significantly decreased in both groups. The percent change in the MDS TBR of the index vessel (primary outcome) did not differ significantly between the 2 groups (-8.41 ± 15.9% vs -8.08 ± 17.0%, respectively, P = .936). Likewise, the percent change in the whole vessel TBR of the index vessel did not differ significantly between the 2 groups. There were significant decreases in total and LDL cholesterol levels in both groups at follow-up (P < .001). There were no significant correlations between the percent changes in MDS TBR of the index vessel, changes in the lipid, and high-sensitive C-reactive protein levels. The reduction in carotid atherosclerotic plaque inflammation by statin/ezetimibe combination therapy was equivalent to that by the statin monotherapy.
他汀/依折麦布联合治疗是否可作为一种有用且等效的替代他汀单药治疗，以减少动脉粥样硬化斑块炎症，目前仍不确定。本研究旨在通过 18F-氟脱氧葡萄糖（18FDG）正电子发射断层扫描（PET）/计算机断层扫描（CT）成像比较他汀/依折麦布联合治疗与他汀单药治疗对颈动脉粥样硬化斑块炎症的影响。本研究数据来自两项临床试验，这些试验采用连续 18FDG PET/CT 检查来研究降脂治疗对颈动脉粥样硬化斑块炎症的影响。主要结局是在 6 个月随访时，最严重病变节段（MDS）内指数血管的靶/背景比（TBR）的百分比变化。两组间的基线特征基本相似。在 6 个月随访时，两组的指数血管 MDS TBR 均显著降低。指数血管 MDS TBR 的百分比变化（主要结局）在两组间无显著差异（-8.41±15.9%与-8.08±17.0%，P=0.936）。同样，指数血管的全血管 TBR 的百分比变化在两组间也无显著差异。两组在随访时总胆固醇和 LDL 胆固醇水平均显著降低（P<0.001）。指数血管 MDS TBR 的百分比变化与血脂和高敏 C 反应蛋白水平的变化之间无显著相关性。他汀/依折麦布联合治疗可使颈动脉粥样硬化斑块炎症减少，其效果与他汀单药治疗相当。
