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利用斑块得分测量,以评估在降脂治疗动脉粥样硬化斑块负.pdf

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784JournalofAtherosclerosisandThrombosisVol.18,No.9AssessmentofChangesinPlaqueBurdenwithPlaqueScoring785 OriginalArticle TheUseofPlaqueScoreMeasurementstoAssessChangesin AtheroscleroticPlaqueBurdenInducedbyLipid-LoweringTherapy OverTime:TheMETEORStudy SanneA.E.Peters1,SonerDogan1,2,RudyMeijer3,MikeK.Palmer4,DiederickE.Grobbee1, JohnR.CrouseⅢ5,DanielH.O’Leary6,GregoryW.Evans7,JoelS.Raichlen8andMichielL.Bots1 onbehalfoftheMETEORinvestigators 1JuliusCenterforHealthSciencesandPrimaryCare,Utrecht,TheNetherlands 2Altrecht,Utrecht,TheNetherlands 3BioClinica,Leiden,TheNetherlands 4KeeleUniversity,Keele,UK 5DepartmentofMedicine,WakeForestUniversitySchoolofMedicine,Winston-Salem,NC,USA 6CaritasCarneyHospital,Boston,MA,USA 7DepartmentsofBiostatisticalSciencesandNeurology,WakeForestUniversitySchoolofMedicine,Winston-Salem,NC,USA 8AstraZeneca,Wilmington,DE,USA Aim:Toevaluatewhetherplaquescoringmeasurementsareabletotrackchangesinatherosclerotic plaqueburdenovertimeandtostudywhetherthisisaffectedbylipid-loweringtherapy. Methods:DatausedwerefromMETEOR(MeasuringEffectsonIntima-MediaThickness:anEvalua- tionOfRosuvastatin),arandomizedcontrolledtrialofrosuvastatin40mgamong984low-riskpatients withmodestcarotidintima-mediathickening(CIMT).Inthisanalysis,duplicateultrasoundimages from12carotidsiteswerecollectedatthebaselineandendofthestudyfrom495Europeanpatients andwereevaluatedforplaquepresenceandseverity.Plaqueswerescoredfromnearandfarwallsofthe 12sites(0=none;1=minimal;2=moderate;3=severe)andplaquescores(PS)werecombinedintotwo summarymeasuresforeachexamination.TheMeanMaxPSisthemeanoverthe12carotidsitesofthe maximumscoreateachsiteandtheMaxMaxPSreflectsthemostseverelesionatanysite. Results:BaselineMeanMaxPSandMaxMaxPSwere0.31(SD:0.20)and1.15(SD:0.51),respec- tively.ChangesinMeanMaxPSandMaxMaxPSsignificantlydifferedbetweenrosuvastatinandpla- cebo(meandifference:－0.03[SE:0.01;p=0.016]and－0.09[SE:0.04;p=0.027],respectively).In contrasttorosuvastatin,whichdemonstratednochangefromthebasel