Influence of intensive lipid lowering with atorvastatin on carotid intima-media thickness and vascular endothelia function in patients with geriatric carotid plaque / 中国综合临床

ABSTRACT

Objective To observe the changes of carotid intima-media thickness(CIMT) and vascular endothelia function in patients with geriatric carotid plaque before and after intensive lipid lowering was performed.Methods 102 patients diagnosed with carotid plaque were ramdomly divided into common group (atorvastatin 10 mg/d,n=48) and intensive lipid lowering group (atorvastatin 20 mg/d,n=54).After one year of treatment,the fasting venous blood total cholesterol (TC),low density lipoprotein cholesterol (LDL-C),high density lipeprotein cholesterol (HDL-C) and triglyceride (TG) were assayed,and the thickest and thinnest CIMT and brachial arterial.endothelium dependent diastolic function (FMD) and carotid artery plaque index(PI) were measured by ultrasound.Results Two groups in the thickest CIMT and PI had no significant difference before and after treatment (P＞0.05).The levels of FMD,TC,LDL-C,TG and the thinnest CIMT had significant difference before and after therapy [common groupGIMT(0.85±0.20)mm,(0.83±0.22) mm,FMD(3.85±1.41)%,(7.91±1.05)%,TC(6.46±1.05) mmol/L,(4.82±1.26) mmol/L,LDL-C (4.71±1.00) mmol/L,(3.16±1.00) mmol/L,TG (1.55±0.45) mmol/L,(1.49±0.44) mmol/L;intensive lipid lowering groupCIMT(0.84±0.20) mm,(0.63±0.17) mm,FMD (3.74±1.38) %,(0.25±1.58)%,TC (6.36±1.06) mmol/L,(4.10±1.00) mmol/L,LDL-C (4.73±1.01) mmol/L、(2.28±1.26) mmol/L,TG (1.56±0.53) mmol/L,(1.50±0.49) mmol/L,P＜0.05].After one year's therapy,the difference in intensive lipid lowering group was more obvious than in common group (P＜0.05).Conclusions Intensive lipid lowering therapy is more effective to decrease TC,LDL-C and CIMT and to improve the vascular endothelia function.Atorvastatin is effective to stabilize the plaque and to retard the atheroscleresis development.