使用PCSK9抑制剂对非致病冠状动脉病变的变化:随机对照,安慰剂控制的FITTER试验
Frans B Mensink1, Jonathan Los1, Mohamed M Reda Morsy2
1Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands.
概括
在高强度他类药物治疗中添加的evolocumab在12周内,在急性冠状动脉综合征患者中没有改善冠状动脉损伤功能或脂质核心负担. 这项研究评估了分数流量储备 (FFR) 和脂质核心负担指数 (maxLCBI4mm).
科学领域:
- 心脏病学 心脏病学
- 医疗成像医学成像
- 药理学 药理学是指药理学的学科.
背景情况:
- 长时间的降脂疗法可以诱导斑块回归并改善动脉样硬化病变形态.
- 高强度他类药物治疗 (HIST) 是治疗动脉样硬化心血管疾病的基石.
研究的目的:
- 评估在患有急性冠状动脉综合征 (ACS) 的患者中,将evolocumab添加到高强度他类药物治疗 (HIST) 的短期疗效.
- 评估使用分量流量储备 (FFR) 和多模式冠状动脉成像对非罪祸首冠状动脉病变的影响.
主要方法:
- 一项随机试验涉及150名患有多血管疾病的ACS患者,他们与HIST一起接受了evolocumab或安慰剂12周.
- 连续的FFR和血管内超声波 (IVUS) 近红外光谱成像在非罪祸首的血管上进行.
- 主要终点包括FFR的变化和最大脂质核心负担指数 (maxLCBI4mm).
主要成果:
- 在evolocumab和安慰剂组之间的FFR平均变化没有显著差异 (调整后的平均差异: -0.01;p=0.6).
- 两组之间maxLCBI4mm的平均变化没有显著差异 (调整后的平均差异:7.8;p=0.8).
- 在任何IVUS衍生的动脉瘤体积参数中,没有观察到组间的差异.
结论:
- 在ACS患者中,在12周内将evolocumab添加到HIST中并没有显著改善非罪祸首冠状动脉病变的FFR或maxLCBI4mm.
- 这些发现表明,在这种情况下,短期的evolocumab治疗不会导致病变生理学或组成的可测量的改善.
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