血脂异常及斑块干预策略.pptVIP

* Because the axial resolution of IVUS-VH is between 100 and 150 lm, it is assumed that the absence of visible fibrous tissue overlying a necrotic core suggested a cap thickness below 100–150 lm and used the absence of such tissue to define a thin fibrous cap. Giuseppe M. Sangiorgi,et al. Catheterization and Cardiovascular Interventions 2007; 70:203–210 A 76-week open-label trial was performed at 37 centers in Japan. Eligible patients began treatment with rosuvastatin 2.5 mg/day, which could be increased at 4-week intervals to ≤20 mg/day. A total of 214 patients underwent intravascular ultrasound (IVUS) at baseline; 126 patients had analyzable IVUS images at the end of the study. The change in the serum low-density lipoprotein-cholesterol level from baseline to end of follow-up was –38.6±16.9%, whereas that of high-density lipoprotein-cholesterol was +19.8±22.9% (both P 0.0001). Percent change of plaque volume, the primary endpoint, was –5.1±14.1% (P0.0001). Conclusions: Rosuvastatin exerted significant regression of coronary plaque volume in Japanese patients with stable CAD, including those who had previously used other lipid-lowering drugs. Rosuvastatin might be useful in the setting of secondary prevention in patients with stable CAD. * * 今年JACC心脏介入杂志发表了一篇评估氟伐他汀对斑块作用的文章，不但评估了他汀对斑块体积的影响，也同时评估了他汀对斑块组份的影响 * 这是同一血管节段,冠脉造影，灰阶IVUS和VH IVUS对它的显像。可以看到IVUS较冠脉造影更明显的显示斑块的大小，而VH IVUS则更好的显示斑块的具体结构。 * 研究对象为80例稳定型心绞痛患者，以血清总胆固醇（TC）220mg/dl和低密度脂蛋白胆固醇（LDL-C）140mg/dl为分界线，高于此线者入选氟伐他汀组（n=40），给予氟伐他汀60 mg/d。低于此线者设为对照组（n=40），予以控制饮食等一般治疗。两组患者在年龄、性别、合并疾病、联合用药和血管病变程度上均具有可比性，随访12个月。治疗前后均采用灰阶IVUS和VH IVUS分别检测斑块体积和其各成份（纤维、纤维脂肪组织、钙沉积和坏死核心）的体积。测量者为富有经验的操作者并且不知道所测患者的基线临床情况和血管损伤情况。 Objectives The aim of this study was to evaluate the effect of treatment with statins on the progression of coronary atherosclerotic plaques of a nonculprit vessel by serial volumetric virtual histology (VH) intravascular ultrasound (IVUS). Background Recent clinical trials have demonstrated a reduction of a