ASCVD患者逆转斑块他汀治疗专家共识

廖玉华; 程翔; 黄恺; 张运; 张澄; 杨跃进; 李建军; 唐熠达; 葛均波; 钱菊英

doi:10.13201/j.issn.1001-1439.2015.01.001

ASCVD患者逆转斑块他汀治疗专家共识

- 1. 华中科技大学协和医院心血管病研究所(武汉, 430022);
- 2. 山东大学齐鲁医院心内科;
- 3. 北京阜外心血管病医院;
- 4. 复旦大学上海中山医院心内科

详细信息

通讯作者: 廖玉华,E-mail:liaoyh27@163.com

中图分类号: R541.4

收稿日期: 2015-01-09

Expert consensus on statin-induced plaque regression in patients with atherosclerotic cardiovascular disease

- 1. Institute of Cardiology, Union Hospital, Huazhong University of Science and Technology, Wuhan, 430022, China;
- 2. Department of Cardiology, Qilu Hospital, Shandong University;
- 3. Fuwai Hospital, Peking Union Medical College;
- 4. Department of Cardiology, Zhongshan Hospital, Fudan University

More Information

Corresponding author: LIAO Yuhua, E-mail: liaoyh27@163.com

Received Date: 09 January 2015

摘要

摘要: 他汀降低低密度脂蛋白胆固醇（LDL-C）可以显著减少动脉粥样硬化性心血管疾病（ASCVD）事件。分析6项他汀治疗冠心病患者血管内超声（IVUS）评价冠状动脉（冠脉）斑块体积变化的临床试验：他汀治疗后LDL-C显著降低到1.4~2.1 mmol/L （53~79 mg/dl）冠脉斑块体积保持稳定，若同时升高载脂蛋白A1（Apo-A1）>9%（达到1.35~1.5 g/L）和高密度脂蛋白胆固醇（HDL-C）>8%（达到1.2~1.4 mmol/L）（45~55 mg/dl），可以观察到冠脉斑块的逆转。这可以作为他汀类药物治疗减少胆固醇流入斑块和增加胆固醇流出斑块的目标值，对ASCVD防治具有重要指导意义。
- 他汀类 /
- 斑块逆转 /
- 低密度脂蛋白胆固醇 /
- 高密度脂蛋白胆固醇 /
- 动脉粥样硬化性心血管疾病
Abstract: Statins reduce atherosclerotic cardiovascular disease (ASCVD) events significantly by lowering low-density lipoprotein cholesterol (LDL-C) levels. We summarized six clinical trials in which intravascular ultrasound (IVUS) was used to assess change of coronary plaque volume in patients with coronary heart disease after statin therapy. The results showed that coronary plaque volume remained no progression when LDL-C level was reduced to 1.4~2.1 mmol/L (53-79mg/dL) after statin treatment, while coronary atherosclerotic plaque regression was observed when apolipoprotein A1 (Apo-A1) reached 1.35~1.5 g/L (>9% increase from baseline) and high-density lipoprotein (HDL-C) reached 1.2~1.4 mmol/L (45~55 mg/dL) (>8% increase from baseline). These data could be the optimal targets of statin therapy which effectively decrease cholesterol influx into plaque while increase cholesterol efflux from plaque, and have important implications for prevention and treatment of ASCVD.
- statins /
- plaque regression /
- low density lipoprotein cholesterol /
- high density lipoprotein cholesterol /
- atherosclerotic cardiovascular disease

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