依折麦布联合阿托伐他汀对LDL-C未达标急性冠脉综合征患者易损斑块的影响

doi:10.3969/j.issn.1002-1949.2017.11.013

Chinese Journal of Critical Care Medicine

2017, Vol. 37

Issue (11): 1024-1028 DOI: 10.3969/j.issn.1002-1949.2017.11.013

Influence on vulnerable plaque of ACS patients with disqualified index of LDL-C by ezetimibe combined with atorvastatin

Li Zhao-hui, Tian Feng, Liu Xin-min

Department of Cardiology, the Second Affiliated Hospital of Henan University of Science and Technology, Luoyang 471000, China

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Abstract Objective: To explore the serum lipid level and influence on vulnerable plaque of acute coronary syndrome (ACS) patients with disqualified index of low density lipoprotein-cholesterol (LDL-C) by ezetimibe combined with atorvastatin, to provide references to its clinical diagnosis, treatment and prognosis evaluation. Methods: ACS patients with disqualified index of LDL-C after regular treatment by atorvastatin were selected as research cases, and were randomly divided into two groups, and with 68 effective cases in observation group, 65 cases in control group. Based on ACS′ conventional and comprehensive treatment, intensive lipid lowing therapy were adopted in control group with atorvastatin of 40 mg/d, yet patients in observation group were treated by ezetimibe (10 mg/d) combined with atorvastatin (20 mg/d), and they were all treated for 1 courses with 4 weeks. Serum lipid and high-sensitivity C-reactive protein (hs-CRP) levels were compared between two groups before treatment and 3 courses after treatment, and intravascular ultrasound (IVUS) index were compared between two groups before treatment (after CAG) and 6 courses after treatment. Major adverse cardiac events (MACE) and drug reactions were recorded during follow-up for 12 months. Results: 3 courses after treatment, two groups′ serum TC, LDL-C and hs-CRP levels were all decreased (t=4.55~7.13, P＜0.05 or P＜0.01), and observation group′s serum TC, LDL-C and hs-CRP levels were all lower than those in control group (t=3.61~4.70, P＜0.05). 6 courses after treatment, two groups′ minimum lumen area and fibrous plaque′s proportion were all increased, and plaque area, plaque burden and soft plaque′s proportion were all decreased (t=4.36~6.51, P＜0.05 or P＜0.01), and observation group′s minimum lumen area and fibrous plaque′s proportion were both higher than those in control group, and plaque area, plaque burden and soft plaque′s proportion were both lower than those in control group (t=3.55~4.64, P＜0.05). During follow-up, observation group′s proportion of angina pectoris′ recurrence (6.06% vs. 20.97%), myocardial infarction′s recurrent (3.03% vs. 14.52%) were both lower than that in control group (χ2 =6.17 and 5.37, P＜0.05). Except 2 cases of liver function′s damage in control group, there was no obvious drug reaction in other patients in the two groups. Conclusion: It has good synergistic effect and clinical efficacy on treatment of ACS patients with disqualified LDL-C by ezetimibe combined with atorvastatin, further reduces serum LDL-C level, enhances vulnerable plaque′s stability, and reduces the risk of adverse cardiac events, also has higher security, so it is superior to intensive therapy by atorvastatin, and it has some reference on clinical treatment of ACS patients with disqualified LDL-C.

Received: 23 June 2017

About author:: Li Zhao-hui, E-mail: zhangh3258@163.com

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Li Zhao-hui,Tian Feng,Liu Xin-min. Influence on vulnerable plaque of ACS patients with disqualified index of LDL-C by ezetimibe combined with atorvastatin[J]. Chinese Journal of Critical Care Medicine, 2017, 37(11): 1024-1028.

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2017.11.013 OR http://www.cnemergency.org.cn/EN/Y2017/V37/I11/1024

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