纯化二十碳五烯酸与混合二十碳五烯酸药物治疗对冠状动脉斑块体积的影响：前瞻性冠状动脉影像学试验的网络荟萃分析

IF 2.5 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Acta cardiologica Pub Date : 2025-08-12 DOI:10.1080/00015385.2025.2538404

John P Sheppard, Suvasini Lakshmanan, Leonard Palatnic, Suraj Dahal, Sion K Roy, Deepak L Bhatt, Matthew J Budoff, John R Nelson

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引用次数: 0

摘要

背景：二十碳五烯酸（EPA）可降低心血管事件风险，但EPA与二十二碳六烯酸（EPA/DHA）混合并没有一致的益处。EPA与EPA/DHA对冠状动脉斑块的比较作用尚不清楚。方法：我们系统地回顾了随机接受他汀+ EPA或他汀+ EPA/DHA治疗的患者与他汀单药治疗相比冠状动脉斑块体积的试验，并使用网络meta分析来比较这些治疗中总冠状动脉斑块体积和脂质斑块体积的百分比变化。结果：在553篇文章中，10项试验包括860例患者符合纳入标准。通过随机效应分析，他汀类药物、他汀类药物+ EPA和他汀类药物+ EPA/DHA对总斑块体积的影响分别为+1.9%[-3.4%,+7.2%]、-10.0%[-17.5%,-2.5%]、-3.3%[-14.2%,+7.5%]，对脂质体积的影响分别为+1.3%[-4.7%,+7.4%]、-21.5%[-32.1%,-10.8%]、-6.1%[-18.9%,+6.7%]。与他汀类药物相比，他汀+ EPA在冠状动脉斑块体积减少方面取得了更大的效果（总体积：SMD = 0.60, p = 0.0017），但他汀+ EPA/DHA没有差异(总体积：SMD = 0.19, p = 0.19；脂质体积：SMD = 0.43, p = 0.38)。结论：当冠状动脉疾病患者服用他汀类药物时，EPA而非EPA/DHA与冠状动脉斑块负担的减少有关。

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Effects of purified eicosapentaenoic acid versus mixed eicosapentaenoic/docosahexaenoic acid pharmacotherapies on coronary plaque volume: network meta-analysis of prospective coronary imaging trials.

Background: Reduced cardiovascular event risk is observed with eicosapentaenoic acid (EPA), but EPA mixed with docosahexaenoic acid (EPA/DHA) does not show consistent benefit. Comparative effects of EPA versus EPA/DHA on coronary plaque remain unclear.

Methods: We systematically reviewed trials measuring coronary plaque volume in patients randomised to statin + EPA or statin + EPA/DHA therapy compared to statin monotherapy, and used network meta-analysis to compare percent change in total and lipid coronary plaque volumes on these treatments.

Results: Among 553 articles, ten trials comprising 860 patients met inclusion criteria. Among statin, statin + EPA, and statin + EPA/DHA respectively, random effects analysis yielded changes of +1.9% [-3.4%, +7.2%], -10.0% [-17.5%, -2.5%], and -3.3% [-14.2%, +7.5%] in total plaque volume and +1.3% [-4.7%, +7.4%], -21.5% [-32.1%, -10.8%], and -6.1% [-18.9%, +6.7%] in lipid volume. Compared with statin, statin + EPA achieved greater percent reduction in coronary plaque volumes (total volume: SMD = 0.60, p < 0.0001; lipid volume: SMD = 1.1, p = 0.0017) but statin + EPA/DHA showed no difference (total volume: SMD = 0.19, p = 0.19; lipid volume: SMD = 0.43, p = 0.38).

Conclusions: EPA but not EPA/DHA is associated with reductions in coronary plaque burden when given as adjunct to statins in patients with coronary artery disease.

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来源期刊

Acta cardiologica 医学-心血管系统

CiteScore

2.50

自引率

12.50%

发文量

115

审稿时长

2 months

期刊介绍： Acta Cardiologica is an international journal. It publishes bi-monthly original, peer-reviewed articles on all aspects of cardiovascular disease including observational studies, clinical trials, experimental investigations with clear clinical relevance and tutorials.