大剂量他汀类药物治疗对冠状动脉粥样硬化消退的影响:ASTEROID试验  

Effect of very high-intensity statin therapy on regression of coronary atherosclerosis:The ASTEROID trial

作　　者：Nissen S. E. Nicholls S. J. Sipahi I. 任付先(译) 唐玉敏(校) 

机构地区：[1]Department of Cardiovascular Medicine,Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195, United States [2]不详

出　　处：《世界核心医学期刊文摘（心脏病学分册）》2006年第9期5-6,共2页

摘　　要：Context: Prior intravascular ultrasound(IVUS) trials have demonstrated slowing or halting of atherosclerosis progression with statin therapy but have not shown convincing evidence of regression using percent atheroma volume(PAV), the most rigorous IVUS measure of disease progression and regression. Objective: To assess whether very intensive statin therapy could regress coronary atherosclerosis as determined by IVUS imaging. Design and Setting: Prospective, open-label blinded endpoints trial(A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound-Derived Coronary Atheroma Burden[ASTEROID]) was performed at 53 community and tertiary care centers in the United States, Canada, Europe, and Australia. A motorized IVUS pullback was used to assess coronary atheroma burden at baseline and after 24 months of treatment. Each pair of baseline and follow-up IVUS assessments was analyzed in a blinded fashion. Patients: Between November 2002 and October 2003, 507 patients had a baseline IVUS examination and received at least 1 dose of study drug. After 24 months, 349 patients had evaluable serial IVUS examinations. Intervention: All patients received intensive statin therapy with rosuvastatin, 40 mg/d. Main Outcome Measures: Two primary efficacy parameters were prespecified: the change in PAV and the change in nominal atheroma volume in the 10-mm subsegment with the greatest disease severity at baseline. A secondary efficacy variable, change in normalized total atheroma volume for the entire artery, was also prespecified. Results: The mean(SD) baseline low-density lipoprotein cholesterol(LDL-C) level of 130.4(34.3) mg/dL declined to 60.8(20.0) mg/dL, a mean reduction of 53.2%(P< .001). Mean(SD) high-density lipoprotein cholesterol(HDL-C) level at baseline was 43.1(11.1) mg/dL, increasing to 49.0(12.6) mg/dL, an increase of 14.7%(P< .001). The mean(SD) change in PAV for the entire vessel was -0.98%(3.15%), with a median of-0.79%(97.5%CI,-1.21%to-0.53%)(P<.001 vs baseline). The mean(SD) change in atheroma voluContext： Prior intravascular ultrasound（IVUS） trials have demonstrated slowing or halting of atherosclerosis progression with statin therapy but have not shown convincing evidence of regression using percent atheroma volume （PAV）, the most rigorous IVUS measure of disease progression and regression. Objective： To assess whether very intensive statin therapy could regress coronary atherosclerosis as determined by IVUS imaging. Design and Setting： Prospective, open-label blinded endpoints trial（A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound-Derived Coronary Atheroma Burden[ASTEROID] ） was performed at 53 community and tertiary care centers in the United States, Canada, Europe, and Australia. A motorized IVUS pullback was used to assess coronary atheroma burden at baseline and after 24 months of treatment. Each pair of baseline and follow-up IVUS assessments was analyzed in a blinded fashion. Patients： Between November 2002 and October 2003, 507 patients had a baseline IVUS examination and received at least 1 dose of study drug. After 24 months, 349 patients had evaluable serial IVUS examinations. Intervention： All patients received intensive statin therapy with rosuvastatin, 40 mg/d.Main Outcome Measures： Two primary efficacy parameters were prespecified： the change in PAV and the change in nominal atheroma volume in the 10-mm subsegment with the greatest disease severity at baseline. A secondary efficacy variable, change in normalized total atheroma volume for the entire artery, was also prespecified. Results： The mean（SD） baseline low-density lipoprotein cholesterol （LDL-C） level of 130.4（34. 3） mg/dL declined to 60. 8 （20. 0） mg/dL, a mean reduction of 53.2% （P 〈. 001）.

关 键 词：冠状动脉粥样硬化 药物治疗 D试验 他汀类 大剂量 消退 冠状动脉粥样斑块 低密度脂蛋白胆固醇 

分 类 号：R541.4[医药卫生—心血管疾病]