Role of imaging techniques in the assessment of vulnerable plaques and the effectiveness of lipid-lowering therapy
| Autor: | G. R. Bikbaeva, A. N. Kovalskaya, K. V. Kuznetsova, T. V. Pavlova, D. V. Duplyakov |
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| Jazyk: | ruština |
| Rok vydání: | 2024 |
| Předmět: | |
| Zdroj: | Российский кардиологический журнал, Vol 29, Iss 8 (2024) |
| Druh dokumentu: | article |
| ISSN: | 1560-4071 2618-7620 |
| DOI: | 10.15829/1560-4071-2024-5984 |
| Popis: | The aim was to evaluate the potential of various imaging methods in the diagnosis of vulnerable coronary plaques and their stabilization using various lipid-lowering therapy regimens.The sources were searched in the PubMed database using the following keywords: "vulnerable (unstable) plaque" AND "PCSK9 inhibitors" AND "intravascular ultrasound" OR "optical coherence tomography" OR "computed tomography angiography". As a result, 8 original clinical trials were selected that corresponded to the review purpose. We assessed the results of following studies on plaque imaging and their regression with various lipid-lowering therapy regimens: GLAGVO, ODYSSEY J, PACMAN-AMI, HUYGENS, ALTAIR, ARCHITECT, etc. The results of most studies have established the advantages of a combined regimen of lipid-lowering therapy (statin+PCSK9 inhibitor) in reducing the rate of cardiovascular events in comparison with statin monotherapy. The reduction in plaque volume ranged from 0,95% to 2,13% in patients receiving a combination of lipid-lowering drugs, while in monotherapy, it increased from 0,05% to 0,92% (GLAGOV, PACMAN-AMI). The changes of minimum fibrous cap thickness varied from 18,0-62,67 µm with combined therapy and 13,2-33,19 µm with monotherapy (PACMAN-AMI, Gao F). Lipid arc regression was 57,5о in combination therapy (statin+PCSK9 inhibitor) and 31,4о in statin monotherapy (HUYGENS). Imaging diagnostic methods makes it possible to identify vulnerable plaques, which helps in consideration of combination lipid-lowering therapy. In addition, plaque visualization makes it possible to evaluate the treatment effectiveness. |
| Databáze: | Directory of Open Access Journals |
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