Effects of atorvastatin calcium at varying doses on the neovascularization grade in carotid plaques and its correlation with inflammatory response

LI Rujuan; XIN Guang; LIN Yujie

doi:10.3969/j.issn.1002-7386.2024.16.001

Abstract：Objective To analyze the effects of atorvastatin calcium at varying doses on the neovascularization grading in carotid plaques and its correlation with the inflammatory level by the superb microvascular imaging(SMI).Methods A total of 240 patients with carotid plaques detected by ultrasound who had neovascularization examined by SMI from January 2017 to December 2019 were included.They were assigned into atorvastatin calcium(AT)20mg/d group(n=120)and AT 40mg/d group(n=120)according to the odd-even case number.AT treatment lasted for 3 months.Peripheral blood was collected in the morning before and after 3 months of treatment.Changes in peripheral blood routine indicators,inflammatory factors and neovascularization grading in carotid plaques were analyzed in the two groups before and after treatment.Results End-points or serious adverse events were not reported in both groups during the study period.After 3 months of treatment,the neovascularization grade in carotid plaques was significantly reduced in both groups,which was significantly pronounced in the AT 40mg/d group than the AT 20mg/d group(P＜0.01).There were significantly changes in the low-density lipoprotein-cholesterol(LDL-C)and high-density lipoprotein-cholesterol(HDL-C)levels before and after low-dose AT treatment(P＜0.05),and there were significant differences in the monocyte cell count(MONO),apolipoprotein E(ApoE),LDL-C and HDL-C levels before and after high-dose AT treatment(P＜0.05).An extremely significant difference in the monocytes-to-HDL-C ratio(MHR)was detected in both groups before and after treatment(P＜0.01),and the MHR threshold was significantly lower in the AT 40mg/d group than the AT 20mg/d group(P＜0.01).The neovascularization grade in carotid plaques was positively correlated with MHR.MHR level was significantly different between grade 0 versus Ⅰ,and between grade Ⅱ versus Ⅲ neovascularization after high-dose AT treatment(P＜0.05).Further flow cytometry data showed that high-dose AT treatment could effectively inhibit the proliferation of MONO in the peripheral blood of patients with carotid plaques(P＜0.05).In addition,serum inflammatory factors,such as high-sensitivity C-reactive protein(hs-CRP),interleukin(IL)-1β,IL-6 and tumour necrosis factor alpha(TNF-α)in all patients were significantly reduced than those before treatment(P＜0.05),which were significantly lower in the AT 40mg/d group than the AT 20mg/d group(P＜0.05).Conclusion AT improves the neovascularization grade in carotid plaques and reduces inflammation in the body,and the clinical effect of 40mg/d AT is much more obvious.