Effects of different doses rosuvastatin on carotid vulnerable plaques and cerebral ischemic events in patients with transient ischemic attack: a prospective randomized controlled trial / 国际脑血管病杂志

ABSTRACT

Objective To investigate the effects of different doses rosuvastatin on carotid vulnerable plaques and cerebral ischemic events in patients with transient ischemic attack (TIA).Methods The TIA patients with carotid vulnerable plaques were enrolled retrospectively.They were randomly divided into either a rosuvastatin conventional dose group or a high-dose group.On the basis of conventional treatment,the former was also given rosuvastatin 10 mg/d,and on the basis of conventional treatment,the latter also took rosuvastatin 20 mg/d.The patients were followed up for 6 months.Blood lipid was detected before and after treatment.The carotid intima-media thickness (IMT),atherosclerotic plaque area,and Crouse plaque score were detected with cervical vascular ultrasound.The incidences of cerebral ischemic events were compared within six months after treatment.Results A total of 71 patients were enrolled.There were 35 patients in the conventional-dose group and 36 patients in the high-dose group.Two and one patients were lost to follow up respectively in both the conventional-dose group and the high-dose group.There were no significant differences in baseline total cholesterol (TC) (5.65 ± 1.05 mmol/L vs.5.46 ±0.87 mmol/L;t =0.812,P =0.419),triacylglycerol (TG) (2.85 ± 0.74 mmol/L vs.2.95 ± 0.86 mmol/L;t =0.513,P =0.609),low-density lipoprotein cholesterol (LDL-C) (4.11 ± 0.47 mmol/L vs.4.08 ± 0.33 mmol/L;t =0.304,P =0.761),and high-density lipoprotein cholesterol (HDL-C) (1.27 ± 0.22 mmol/Lvs.1.23 ± 0.20 mmol/L;t =1.339,P =0.185) between the high-dose group and the conventional dose group.After treatment,TC (3.06±0.77 mmol/L vs.4.98 ±0.78 mmol/L;t=10.214,P＜0.001),TG (2.15±0.56 mmol/L vs.2.52 ± 0.68 mmol/L;t =2.492,P =0.015),and LDL-C (2.18 ± 0.59 mmol/L vs.3.86 ± 0.42 mmol/L;t =13.526,P＜0.001) in the high-dose group were significantly lower than those in the latter,while HDL-C (1.43 ±0.20 mmol/L vs.1.33 ± 0.21 mmol/L;t =2.010,P =0.048) was significantly higher than the conventional dose group.There were no significant differences in baseline IMT (1.59 ± 0.26 mm vs.1.58 ± 0.28 mm;t =0.152,P =0.879),plaque area (0.87 ± 0.29 mm2 vs.0.85 ± 0.34 mm2;t =0.261,P =0.749),and Crouse score (4.26 ± 0.31 mm vs.4.18 ± 0.25 mm;t =1.171,P =0.245) between the high-dose group and the conventional dose group;after treatment,IMT (1.26 ± 0.25 mm vs.1.44 ±0.27 mm;t =2.852,P=0.005),plaque area (0.50±0.25 mm2 vs.0.70±0.25 mm2;t=3.298,P=0.001),and Crouse score (2.30 ±0.26 mm vs.4.03 ±0.24 mm;t =28.509,P ＜0.001) in the high-dose group were significantly decreased compared with the conventional dose group.The incidence of cerebral ischemic events in the high-dose group was significantly lower than that in the conventional dose group (11.76％ vs.29.41％;x2 =3.202,P =0.001).Conclusions Rosuvastatin has significant lipid-lowering effect.It can eliminate or stabilize carotid vulnerable plaque and reduce ischemic stroke events.The effect of rosuvastatin 20 mg/d is superior to that of rosuvastatin 10 mg/d.