Effects Of Intensive Treatment Of Statin Towards Atherosclerosis Plaques In Patients With Borderline Vulnerable Plaque Lesion

Objective To compare the efficacy and safety of atorvastatin intensive treatmenttowards borderline vulnerable plaque lesion in unstable angina pectoris (UAP) patients byintravascular ultrasound.Methods （1） A total of100patients undergoing coronary angiography (CAG) withborderline lesion (coronary artery stenosis between50%~70%), who were divided into twogroups, the intensive treatment group and the common treatment group. laboratory testinclude routine urine and blood tests, lipids, blood glucose, liver function, renal function,creatine kinase (CK) and high-sensitivity C-reactive protein（hs-CRP）。 One50%~70%stenosis plaque was selected as target plaque in each patient. Coronary artery angiography(CAG) and target plaque intravascular ultrasound (IVUS) were performed on admission.（2）Since existing clinical medication individual difference and in order to ensure thedrug safety, Continued after the first weekly dose of the statintreatmentgroup atorvastatin20mg/d, the second week of a dose of40mg/d, the third week of a doseof60mg/d, the fourth weekly dose of80mg/d, taking eightmonths, the controlgrouptaking atorvastatin dose was20mg/d, continued to take nine months. Bothgroupsweekly clinical follow-up after discharge, the basic data collection, monthly laboratorytests (liver function, kidney function, muscle enzymes and hs-CRP), All patients werefollowed up for9months or until death, aboutangina symptoms and adverse events, clinicaleventsrecorded heart: re-hospitalization for unstable angina,acute myocardial infarction, targetvesselrevascularization, cardiac death (heart failuredeterioration, malignant arrhythmia, fatal myocardialinfarction or sudden death).（3） All patients were followed up again at the end ofhospital review coronaryangiography and intravascular ultrasound. Coronary angiography observed degree ofchange in the critical lesions before and after treatmentof the two groupsof coronary stenosis; observe thetreatment of blood lipids and hs-CRP before and afterthe change; intravascular ultrasound treatment were observed before andafter coronary critical lesions of atherosclerotic plaque volume changes; the two timestheresults recorded in the off disk virtue intraVascular imaging (Beijing, China) software tomeasure, measure only for lesions more than10mm in length, includinglength of10mm,including the most important region of the plaqueburden. The use of coronary axial flag (suchas coronaryartery calcification site),2IVUS analysis ofparts of the same.1mm spacing measurementof bloodvessel volume, lumen volume and plaque volume,plaquevolume, lumen volume and vessel volumechanges before and after treatment.Results （1）100patients completed the clinical follow-up,62patientscompleted the entire medication process, and CAG and IVUS review. Strengthen the group of32control group of30people,18of the treatment groupdiscontinuing treatment because ofdrug side effects,the control group4discontinued treatment due toadverse drugreactions, three because of clinical symptoms to withdraw from the study underwentcoronary intervention treatment plant into the bracket,and13people on theirown to give up CAG and IVUSreview.（2）Clinical efficacy: treatment group, the total efficiency of45(90.0), the control group and16(32.0).（3） The two groups of drug therapy in patients withhyperlipidemia, plasma CRPconcentrations were significantly lower in the treatment group decreased more significantly.。（4） The plaque, nine months after the control group, plaque volume increased (P <0.05), treatment group, no significant change (P>0.05).Conclusions Atorvastatin intensive therapy can prevent the development ofatherosclerotic plaque of UAP patients.