Veinot J P, Edwards W D, Camrud A R, Jorgenson M A, Holmes D R, Schwartz R S
Section of Medical Pathology, Mayo Graduate School of Medicine, Mayo Clinic and Foundation, Rochester, Minnesota, USA
Can J Cardiol. 1996 Jan;12(1):65-70.
To assess the effectiveness of lovastatin, an HMGCoA reductase inhibitor, in the inhibition of coronary arterial restenosis post-balloon angioplasty.
Randomized single-blind study comparing the degree of restenosis in a control and lovastatin group of animals with similar degree of arterial injury.
Seventeen domestic cross-bred pigs received either oral lovastatin (11 animals) or no lovastatin (six animals).
The pigs received 20 mg of oral lovastatin twice daily or no drug. All pigs received acetylsalicylic acid and verapamil preprocedure. One or more coronary arteries were injured by deployment of tantalum wire stents delivered on oversized percutaneous transluminal coronary angioplasty balloons. The balloons were intentionally overexpanded to create arterial injury. The animals were sacrificed at 28 days. The arteries were cross-sectioned and evaluated blindly by quantitative histomorphometry. The amounts of arterial injury and neointimal thickening were quantitated. A series of linear regression models was used to control for the degree of injury.
The reduction of neointimal thickness for the lovastatin group compared with the control animals was 0.08 mm, a statistically significant result (P < 0.05).
Although lovastatin produced a statistically significant decrease in neointimal thickness post-balloon angioplasty, when extrapolated to angiographical end-points, the differences would not be clinically significant. These data suggest that lovastatin may be of marginal use in humans for limiting restenosis.
评估HMGCoA还原酶抑制剂洛伐他汀对球囊血管成形术后冠状动脉再狭窄的抑制效果。
随机单盲研究，比较动脉损伤程度相似的对照组和洛伐他汀组动物的再狭窄程度。
17只国内杂交猪，其中11只口服洛伐他汀，6只未服用洛伐他汀。
猪每天口服20毫克洛伐他汀两次或不服用药物。所有猪在手术前均接受阿司匹林和维拉帕米治疗。通过在超大尺寸经皮腔内冠状动脉成形术球囊上放置钽丝支架来损伤一条或多条冠状动脉。故意使球囊过度扩张以造成动脉损伤。28天后处死动物。对动脉进行横断面切片，并通过定量组织形态学进行盲法评估。对动脉损伤和新生内膜增厚的程度进行定量。使用一系列线性回归模型来控制损伤程度。
与对照动物相比，洛伐他汀组新生内膜厚度减少了0.08毫米，这是一个具有统计学意义的结果（P<0.05）。
虽然洛伐他汀在球囊血管成形术后使新生内膜厚度有统计学意义的降低，但外推至血管造影终点时，差异在临床上无显著意义。这些数据表明，洛伐他汀在人类中限制再狭窄的作用可能有限。
