| Objective:Non-invasive arterial stiffness brachial-ankle pulse wave velocity (baPWV) and ankle-brachial index (ABI) are strong predictors of all-cause mortality and cardiovascular disease, as cardiovascular disease risk factors. Control of risk factors is the main measures in preventing or treating cardiovascular diseases and complications. At present, there are few studies on drug treatment of non-invasive atherosclerosis indicators. In this study, we investigated effects of probucol and trimetazidine (TMZ) on baPWV and ABI in patients with unstable angina undergoing percutaneous coronary intervention (PCI). Moreover, we discuss the risk factors of baPWV and ABI, as well as relationship with cardiovascular disease.Methods:We consecutively selected152patients with unstable angina underwent percutaneous coronary intervention, including males95cases, females57cases, aging from36to83years old, average (64.35±10.06) years old, from Department of Cardiology, Second Hospital of Tianjin Medical University from March2011to December2012. All patients were randomly divided into three groups:control group of55cases, probucol group of51cases, and TMZ group of46cases. In control group, patients were granted with routine drugs, such as aspirin, clopidogrel, low molecular weight heparin. nitrates, statins, beta blockers, ACE inhibitors and other routine drugs. On the basis of routine therapy, patients in probucol group and TMZ group, were treated with probucol0.5g bid and TMZ20mg tid, respectively, at least24hours before PCI and continuance of fifteen to ninety days. In detail, we recorded age, gender, history of smoking, alcohol, hypertension, diabetes, hypercholesterolemia, stroke and myocardial infarction of all patients. All patients underwent examinations of clinical biochemical indicators such as routine blood, coagulation, liver function, kidney function, blood sugar, electrolytes, myocardial necrosis markers and echocardiography. Bilateral ABI and baPWV were determined at the same time before PCI and after3months, using a non-invasive atherosclerosis detector VP-1000(BP203RPE Type Ⅱ, PWV/ABI Type) produced by Japan Colin.Results:(1) In control group, both of baPWV and ABI had no significant difference before and after treatment(P>0.05).(2) In probucol group, level of baPWV showed a significant decrease after treatment. from (1600.08±295.00)cm/s to (1527.88±286.36)cm/s (P<0.05); ABI after treatment decreased significantly comparing with baseline value, from1.08±0.14to1.05±0.15(P<0.05), but in a normal range.(3) In TMZ group. baPWV after treatment decreased obviously, from (1657.69± 378.06)cm/s to (1557.27±312.09)cm/s (P<0.05); but no significant difference was noted for ABI (P>0.05).(4) In the three groups, level of baPWV and ABI had no significant difference before treatment (P>0.05); after treatment, baPWV in probucol and TMZ group decreased significantly comparing with control group(P<0.05).(5) Multiple regression analysis showed that age and systolic blood pressure were main influencing factors of baPWV (r=0.437, P<0.01; r=0.588, P<0.01), baPWV positively correlated with coronary lesions severity (P<0.05).(6) Diabetes mellitus and fasting glucose were risk factors of ABI (P<0.05, P<0.01, respectively).Conclusion:(1) Age and systolic blood pressure are main influencing factors of baPWV, brachial-ankle pulse wave velocity positively correlates with severity of coronary lesions.(2) Diabetes and high blood sugar are risk factors of ABI.(3) Probucol could significantly reduce baPWV and improve arterial stiffness. Its mechanism may be related to anti-inflammatory, antioxidant, protecting endothelial function, reducing vascular smooth muscle cells proliferation, and lipid-lowering effects.(4) Trimetazidine can obviously decrease baPWV and improve arterial stiffness. Its mechanism may be related to improving insulin resistance, anti-inflammatory, antioxidant, improving endothelial function and reducing vascular smooth muscle cells proliferation. |
