抄録
Background Currently, there are various types of statins used in the treatment of hyperlipidemia and coronary artery disease. The purpose of this study was to compare the effects of a lipophilic statin (cerivastatin) with those of a hydrophilic statin (pravastatin) on the carotid arterial media using integrated backscatter (IB) ultrasound. Cerivastatin (C) has a strong anti-proliferative effect (APE) on smooth muscle cells (SMCs), whereas pravastatin (P) has a weak effect. Methods and Results The IB values in the media of 72 segments of carotid arteries were measured in 36 patients with hyperlipidemia before and after statin therapy or diet for 6 months (C, n=13: P, n=12: diet, n=11). In addition, IB values of 34 segments of carotid arteries were measured in 34 patients without coronary risk factors. Intima - media thickness (IMT) and arterial stiffness (stiffness β) were measured by conventional echo at the same time. IB values did not significantly change in the P group (12.8±3.5 vs 12.7±2.7 dB), but decreased in the C group (12.1 ±2.9 vs 10.0±2.7 dB, p<0.01). Also, stiffness β did not significantly change in the P group (8.3±3.1 vs 7.6±2.5), but decreased in the C group (10.1±4.3 vs 7.9±3.3, p<0.05). IB values correlated with age (r=0.70, p<0.01) and stiffness β (r=0.67, p<0.01) in the 34 patients without coronary risk factors. Conclusions Statin therapy with cerivastatin, but not pravastatin, decreased the IB values of the carotid media and arterial stiffness. The difference between these 2 statins may be related to their effective dose range. (Circ J 2004; 68: 784 - 790)
