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大剂量他汀类药物治疗对颈动脉内膜中层厚度的潜在调节作用:一项初步研究。

The possible modulatory impact of high-dose statin therapy on carotid intima-media thickness: a preliminary study.

作者信息

Urbanowicz Tomasz K, Gabriel Katarzyna, Spasenenko Ievgen, Krasińska-Płachta Aleksandra, Banaszkiewicz Marta, Filipiak Krzysztof J, Krasiński Zbigniew, Krasińska Beata, Tykarski Andrzej

机构信息

Cardiac Surgery and Transplantology Department, Poznan University of Medical Sciences, Poznan, Poland.

Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland.

出版信息

Postepy Kardiol Interwencyjnej. 2024 Dec;20(4):413-419. doi: 10.5114/aic.2024.145183. Epub 2024 Nov 20.

Abstract

INTRODUCTION

Morbidity related to cardiovascular disease (CVD) is a leading epidemiological problem. Carotid intima-media thickness (CIMT) can be regarded as a surrogate marker for cardiovascular disease. Lipid-lowering agents such as statins have proven to reduce future risk and promote regression of atherosclerotic plaques.

AIM

To relate long-term high-dose statin therapy to CIMT in a retrospective analysis of patients presenting with preserved ejection fraction heart failure (HFpEF).

MATERIAL AND METHODS

There were 77 (47 female and 30 male) consecutive patients with a median age of 69 (62-75) years admitted to the Hypertension and Internal Medicine Department presenting with preserved ejection fraction heart failure symptoms in NYHA class 2.0 (0.5) for clinical evaluation in 2024. Laboratory tests, echocardiography, carotid ultrasound, and cine angiography were performed. The possible relation between CIMT and patients' characteristics was evaluated.

RESULTS

The multivariable model indicated possible relations between CIMT above 0.8 mm and obesity (BMI > 30 kg/m) (OR = 11.86, 95% CI: 2.5-54.02, = 0.001), and high-statin therapy (OR = 0.18, 95% CI: 0.04-0.08, = 0.024). The receiver operator curve (ROC) was characterized by an area under the curve (AUC) of 0.794 with an F-measure of 0.417, yielding a sensitivity of 35.7% and specificity of 91.8%.

CONCLUSIONS

The results from the retrospective single-measurement analysis on long-term statin therapy may indicate the relation between CIMT and rosuvastatin (at least 20 mg/day) or atorvastatin (at least 40 mg/day) administration. Long-term statin therapy is associated with a reduced likelihood of having CIMT above 0.8 mm, although the presented results are statin-type and dosage-dependent.

摘要

引言

与心血管疾病(CVD)相关的发病率是一个主要的流行病学问题。颈动脉内膜中层厚度(CIMT)可被视为心血管疾病的替代标志物。他汀类等降脂药物已被证明可降低未来风险并促进动脉粥样硬化斑块的消退。

目的

在对射血分数保留的心力衰竭(HFpEF)患者的回顾性分析中,探讨长期大剂量他汀类药物治疗与CIMT的关系。

材料与方法

2024年,高血压和内科连续收治了77例(47例女性和30例男性)患者,中位年龄为69(62 - 75)岁,表现为纽约心脏协会(NYHA)心功能分级2.0(0.5)级的射血分数保留的心力衰竭症状,进行临床评估。进行了实验室检查、超声心动图、颈动脉超声和血管造影。评估了CIMT与患者特征之间的可能关系。

结果

多变量模型表明,CIMT大于0.8 mm与肥胖(BMI > 30 kg/m²)(OR = 11.86,95% CI:2.5 - 54.02,P = 0.001)以及高剂量他汀类药物治疗(OR = 0.18,95% CI:0.04 - 0.08,P = 0.024)之间可能存在关联。受试者工作特征曲线(ROC)的曲线下面积(AUC)为0.794,F值为0.417,灵敏度为35.7%,特异性为91.8%。

结论

长期他汀类药物治疗的回顾性单测量分析结果可能表明CIMT与瑞舒伐他汀(至少20 mg/天)或阿托伐他汀(至少40 mg/天)给药之间的关系。长期他汀类药物治疗与CIMT大于0.8 mm的可能性降低有关,尽管所呈现的结果依赖于他汀类药物类型和剂量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bdb2/11783262/ce3f80da4a32/PWKI-20-55171-g001.jpg

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