| 박재형, 김규섭, 박용규, 진선아, 신성균, 김준형, 이재환, 최시완, 정진옥, 성인환 |
Background: The thickening of intima-media thickness (IMT) is an initial event of atherosclerosis. Radial IMT is increased in patients underwent transradial angioplasty because of denudation injury. Recently, the use of statin can halt the progression of the carotid IMT progression. We want to evaluate the effect of statins on the progression of the radial IMT after the transradial intervention.
Methods: Patients underwent transradial angioplasty were randomly assigned to the atorvastatin 20mg or simvastatin/ezetimibe 10mg/10mg group, prospectively. The bilateral radial arteries were examined one day after the intervention, one and six months later.
Result: We enrolled 126 patients (62.6±4years, 85 males), and 62 were allocated to atorvastatin and 64 to simvastatin/ezetimibe group. Baseline clinical characteristics were similar between two groups. Baseline bilateral radial IMT were similar (right 0.35±0.04 vs left 0.35±0.06, p=0.688). Of 126 patients, 79 patients were followed after 6 months (18 were not candidates for follow-up (< 6months), 17 were follow-up lost, 1 died and 1 underwent re-procedure during the study period). With statin treatment, there was significant decrease in cholesterol profiles. However, there was no significant change in high sensitive C-reactive protein concentration. The right radial IMT was significantly increased after 1 month (0.35±0.04 to 0.40±0.06mm, p<0.001). However, incrased right radial IMT was significantly decreased with statin use (0.40±0.06 to 0.35±0.06mm, p<0.01). The left radial IMT was decreased with statin treatment after one month (0.35±0.06 to 0.34±0.04mm, p=0.19) and this effect was maintained to 6 months (0.34±0.04 to 0.33±0.06mm, p=0.85). However, there was no statistical difference between atorvastatin and simvastatin/ezetimibe groups.
Conclusion: Transradial angioplasty was associated with increased radial IMT. However, statin treatment was associated with decrease of thickened radial IMT. Moreover, statin use seemed to be related with decrease of radial IMT in the contra-lateral radial artery.
Table 1. Cholesterol profiles and radial IMT according to statin treatment
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