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| 1 | 极高强度他汀治疗对冠状动脉粥样硬化消退的影响——ASTEROID试验显示文摘背景:以前的血管内超声(intravascular ultrasound,IVUS)试验证实,他汀治疗可减缓或阻止动脉粥样硬化的进展,但是迄今尚无应用动脉粥样斑块体积百分比(percent atheroma volume,PAV)证实粥样硬化消退的确切证据。PAV是最严格的评价病变进展和消退的IVUS测量指标。
目标:评价极高强度他汀治疗是否能逆转IVUS确定的冠状动脉粥样硬化。
设计和地点:于美国、加拿大、欧洲和澳大利亚53个社区和3级保健中心进行前瞻性开标盲法终点试验(A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound-Derived Coronary Atheroma Burden,ASTEROID)。应用马达驱动回撤IVUS评价基线和治疗24个月时冠状动脉粥样斑块负荷。每对基线和随访IVUS测量结果均进行盲法分析。
病例:从2002年11月到2003年10月,507例患者有基线IVUS检查结果,并接受至少1个剂量的研究药物。在24个月后,349例患者具有可用于评估的系列IVUS检查结果。
干预:所有患者均接受瑞舒伐他汀40ms/d强化治疗。
主要观测指标:预先设定了两个一级疗效指标:PAV变化和基线最严重病变10min节段动脉粥样斑块体积变化。二级疗效指标为整个动脉标准化总斑块体积的变化。结果:平均(SD)LDL—C水平由基线时的130.4(34.3)ms/dL降至60.8(20.0)ms/扎,平均下降了53.2%(P〈0.001)。平均(SD)HDL-C水平从基线时的43.1(11.1)ms/dL升至49.0(12.6)ms/dL,平均增加了14.7%(P〈0.001)。整个血管PAV平均(SD)变化为-0.98%(3.15%),中位数为-0.79%(97.5%CI,-1.21%~-0.53%)(与基线比较,P〈0.001)。最严重病变10min节段斑块体积平均(SD)变化为-6.1(10.1)mm^3,中位数为-5.6mm^3(97.5%CI,-6.8~-4.0mm^3)(与基线比较,P〈0.001)。总斑块体积变化中位数降低了6.8%,平均减少了-14.7(25.7)mm^3,中位数为-12.5mm^3(95%CI,-15.1~-10.5mm^3)(与基线比较,P〈0.001)。不良事件少见,与其他他汀试验相似。
结论:应用瑞舒伐他汀40ms/d进行极高强度他汀治疗可使LDL-C平均水平达到60.8ms/dL,使HDL—C增加14.7%。这导致所有3个预先设定的IVUS斑块负荷指标均显示动脉粥样硬化消退。因此,将LDL-C降至低于目前指南规定的水平,同时显著提高HDL-C,可以使冠心病患者动脉粥样硬化斑块消退。这些变化对临床预后的影响尚需进一步研究确定。 | Steven E. Nissen Stephen J. Nicholls Ilks Sipahi Peter Libby Joel S. Raichlen Christie M. Ballantyne Jean Davignon Raimund Erbel Jean Charles Fruchart Jean-Claude Tardif Paul Schoenhagen Tim Crowe Valerie Cain Kathy Wolski Marlene Coormastic E. Murat Tuzcu 仝其广(译) 王淑敏(译) 胡大一(校) | 2006 | 美国医学会杂志(中文版)2006，25，4： | 341 |
| 2 | 瑞舒伐他汀对存在亚临床动脉粥样硬化的低危人群颈动脉内膜中层厚度进展的影响——METEOR试验显示文摘背景:动脉粥样硬化往往在机体出现症状之前就已有所进展。目前,我们尚不清楚Framingham风险评分(Framinghaln risk score,FRS)较低的轻中度亚临床动脉粥样硬化中年人群是否能从治疗中获益。
目的:评价为期2年的他汀类药物治疗能否减缓颈动脉内膜中层厚度(carotid intimamedia thickness,CIMT)继续增厚或使粥样斑块消退。
设计、地点及参试者:“瑞舒伐他汀对内膜中层厚度影响的测评研究(Measuring Effects on Intima-Media Thickness:an Evaluation of Rosuvastatin,METEOR)”是2002年8月至2006年5月在美国及欧洲61个基层医疗中心开展的一项随机、双盲、安慰剂对照研究,共纳入984名参试者,有的参试者仅以年龄(平均年龄,57岁)为冠心病的危险因素,有的参试者10年内FRS低于10%、CIMT重庞增厚(1.2~3.5mm)、LDL胆固醇水平有所升高(平均值,154mg/dL)。
干预:参试者服用40mg瑞舒伐他汀或安慰剂。
主要观测指标:12个颈动脉位点最大CIMT的变化率(经B超检测);颈总动脉位点、颈动脉窦位点及颈内动脉位点最大CIMT的变化,颈总动脉位点平均CIMT的变化。仅在瑞舒伐他汀组中评估CIMT的消退情况。
结果:瑞舒伐他汀组参试者LDL胆固醇平均(SD)水平由基线时的155(24.1)mg/dL降至78(27.5)mg/dL,平均降低49%(与安慰剂组相比P〈0.001)。瑞舒伐他汀组12个颈动脉位点最大CIMT的变化值为-0.0014(95%CI,-0.0041~0.0014)mm/y,安慰剂组12个颈动脉位点最大CIMT的变化值为Q0131(95%CI,Q0087~Q0174)mm/y(P〈0.001)。瑞舒伐他汀组颈总动脉位点最大CIMT的变化值为-0.0038(95%CI,-0.0064~-0.0013)mm/y(P〈0.001),颈动脉窦位点最大CIMT的变化值为-0.0040(95%CI,-0.0090~0.0010)mm/y(P〈0.001),颈内动脉位点最大CIMT的变化值为0.0039(95%CI,-0.0009~0.0088)mm/y(P=0.02)。瑞舒伐他汀组颈总动脉位点平均CIMT的变化值为0.0004(95%CI,-0.0011~0.0019)mm/y(P〈0.001)。P值均为与安慰剂组相比。总的来说,瑞舒伐他汀具有良好的耐受性,很少引发严重的心血管不良事件(在2年内有6名参试者[0.86%]出现8起不良事件[1.1%])。
结论:对于FRS低于10%的亚临床动脉粥样硬化中年人群而言,瑞舒伐他汀能够在2年内显著降低最大CIMT的进展速率,与安慰剂相比差异具有统计学显著性。但是,瑞舒伐他汀无法诱导病变消退。今后,我们仍需开展大型远期试验来明确上述研究结果的临床意义. | John R. Crouse Ⅲ Joel S. Raichlen Ward A. Riley Gregory W. Evans Mike K. Palmer Daniel H. O' Leary Diederick E. Grobbee Michiel L. Bots 李军(译) | 2007 | 美国医学会杂志(中文版)2007，26，4： | 44 |
| 3 | Safety and Efficacy of Achieving Very Low Low-Density Lipoprotein Cholesterol Levels With Rosuvastatin 40 mg Daily (from the ASTEROID Study)显示文摘 | Stephen D. Wiviott Satishkumar Mohanavelu Joel S. Raichlen Valerie A. Cain Steven E. Nissen Peter Libby | 2009 | The American Journal of Cardiology2009，，1： | 1 |
| 4 | Effect of rosuvasta- tin therapy on coronary artery stenosis assessed by quantitative coronary angiography : a study to evaluate the effect of rosuvastatin on intravascu- lar ultrasound -derived coronary atheroma burden 显示文摘 | Ballantyne CM Raichlen JS Nicholls SJ | 2008 | Circulation2008，117，19： | 1 |
| 5 | Effect of rosuvastatin therapy on coronary artery stenoses assessed by quantitative coronary angiography: a study to evaluate the effect of rosuvastatin on intravascular ultrasound-de- rived coronary atheroma burden显示文摘 | Ballantyne CM Raichlen JS Nicholls S J | 2008 | Circulation2008，117，19： | 1 |
| 6 | Effect of rosuvas- tatin therapy on coronary artery stenoses assessed by quantitative coronary angiography: a study to evaluate the effect of rosuvastatin on intravascular ultrasound-derived coronary atheroma burden显示文摘 | Ballantyne CM Raichlen JS Nieholls SJ | 2008 | Circulation2008，117，： | 1 |
| 7 | Runup and rundown generated by three - dimensional sliding masses 显示文摘 | Liu L F Wu T R Raichlen F | 2005 | Journal of Fluid Mechanics2005，536，： | 1 |
| 8 | Effect of rosuvastatin therapy on coronary artery stenoses assessed by quantitative coronary angiography:a study to evaluate the effect of rosuvastatin on intravascular ultrasound-derived coronary atheroma burden显示文摘 | BALLANTYNE C M RAICHLEN J S NICHOLLS S J | 2008 | Circulation2008，117，22： | 1 |
| 9 | The human gluterus maximus and its role in running显示文摘 | Lieberman DE Raichlen DA Pontzer H | 2006 | J Exp Biol2006，209，11： | 1 |
| 10 | Effect of very high-intensity statin therapy on regression of coronary atherosclerosis:the ASTEROID trial显示文摘 | Nissen S E Nicholls S J Sipahi I Libby P Raichlen J S Ballantyne C M | 2006 | JAMA2006，295，： | 1 |
| 11 | Statin therapy alters the relationship between apolipaprotein B and low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol targets in high-risk patients: the MERCURY II (Measuring Effective Reductions in Cholesterol Using Rosuvastatin) trial 显示文摘 | Ballantyne CM Raichlen JS Cain VA | 2008 | J Am Coll Cardiol2008，52，8： | 1 |
| 12 | Nonlinear Oscillations in Rectangular Tanks显示文摘 | Lepelletier T G Raichlen F | | 0，，： | 1 |
| 13 | Effect of rosuvastafin therapy on coronary artery stenoses assessed by quantitative coronary angiography: a study to evaluate the effect of rosuvastatin on intravascular ultrasound-derived coronary atheroma burden 显示文摘 | Ballantyne CM Raichlen JS Nieholls SJ | 2008 | Circulation2008，117，24： | 1 |
| 14 | Statin therapy alters the relationship between apolipoprotein B and lowdensity lipoprotein cholesterol and non-high-density lipoprotein cholesterol targets in high-risk patients:the MERCURY II (Measuring Effective Reductions in Cholesterol Using Rosuvastatin)trial显示文摘 | Ballantyne CM Raichlen JS Cain VA | 2008 | J Am Coll Cardiol2008，52，8： | 1 |
| 15 | Long-term effects of maximally intensive statin therapy on changes in coronary atheroma composition: insights from SATURN显示文摘 | Rishi Puri Peter Libby Steven E. Nissen Kathy Wolski Christie M. Ballantyne Phillip J. Barter M. John Chapman Raimund Erbel Joel S. Raichlen Kiyoko Uno Yu Kataoka E. Murat Tuzcu Stephen J. Nicholls | 2014 | European Heart Journal – Cardiovascular Imaging2014，，： | 1 |
| 16 | Comparison of Lipid-Modifying Efficacy of Rosuvastatin Versus Atorvastatin in Patients With Acute Coronary Syndrome (from the LUNAR Study)显示文摘 | Bertram Pitt Joseph Loscalzo John Monyak Elinor Miller Joel Raichlen | 2012 | The American Journal of Cardiology2012，，9： | 1 |
| 17 | Effect of Rosuvastatin Therapy on Coronary Artery Stenoses Assessed by Quantitative Coronary Angiography: A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound-Derived Coronary Atheroma Burden显示文摘 | Christie M. Ballantyne Joel S. Raichlen Stephen J. Nicholls Raimund Erbel Jean-Claude Tardif Sorin J. Brener Valerie A. Cain Steven E. Nissen | 2008 | Circulation2008，，19： | 1 |
| 18 | Determination of Carotid Artery Atherosclerotic Lesion Type and Distribution in Hypercholesterolemic Patients With Moderate Carotid Stenosis Using Noninvasive Magnetic Resonance Imaging显示文摘 | Baocheng Chu Thomas S. Hatsukami Nayak L. Polissar Xue-Qiao Zhao Lawrence W. Kraiss Dennis L. Parker John C. Waterton Joel S. Raichlen Wendy Hamar Chun Yuan | 2004 | Stroke2004，，11： | 1 |
| 19 | Run-up and run-down generated by three-dimensional sliding masses显示文摘 | LIU L F WU T R RAICHLEN F | 2005 | Journal of Fluid Mechanics2005，536，： | 1 |
| 20 | Effect of rosuvastatin therapy on coronary artery stenoses assessed by quantitative coronary angiography:a study to evaluate the effect of rosuvastatin on intravascular ultrasound-derived coronary atheroma burden 显示文摘 | Ballantyne C M Raichlen J S Nicholls S J | 2008 | Circulation2008，117，19： | 1 |
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