EFFECT OF LIPID MODIFICATION ON PERIPHERAL ARTERIAL DISEASE AFTER ENDOVASCULA

脂质修饰对血管内术后周围动脉疾病的影响

• 批准号: 8166761
• 负责人: CHRISTIE Mitchell BALLANTYNE
• 金额: $ 2.17万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-12-01 至 2010-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8166761
• 关键词: Ankle; Arteries; Atherosclerosis; Blood Tests; Cardiovascular system; Caring; Clinical; Combined Modality Therapy; Computer Retrieval of Information on Scientific Projects Database; Contralateral; Disease; Event; Funding; Grant; High Density Lipoproteins; Image; Imaging technology; Incidence; Inflammation; Institution; Leg; Limb structure; Lipids; Lipoproteins; Low-Density Lipoproteins; Magnetic Resonance Imaging; Measurement; Medical; Modification; Nicotinic Acids; Outcome; Patients; Peripheral arterial disease; Physiologic pulse; Quality of life; Questionnaires; Randomized; Recruitment Activity; Research; Research Personnel; Resolution; Resources; Source; Stents; Symptoms; Thrombosis; Ultrasonography; United States National Institutes of Health; Walking; claudication; ezetimibe; femoral artery; hemodynamics; pressure; restenosis

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The hypothesis for the study is as follows: Intensive lipid modification with combination therapy will inhibit the progression of atherosclerosis and reduce the incidence of restenosis in femoral arteries following endovascular stenting by decreasing thrombosis and inflammation. In general, we will recruit a total of 120 patients with symptomatic femoral artery occlusive disease in one leg. These patients will be treated with endovascular stenting, and then randomized into two treatment groups: 1)standard of medical care including statin therapy; and 2) standard of medical care with intensive lipid modification using a statin plus ezetimibe and extended release niacin to increase HDL (>40) and decrease LDL (<80) and TG (<150). Specifically, we will follow these patients for 2 years and study the following specific aims: 1. To determine the effect of intensive lipid modification therapy on progression of atherosclerosis and restenosis of femoral arteries using high resolution MRI image technology to exam both the stented femoral artery for in-stent restenosis and the contralateral fermoral artery for progression of atherosclerosis. 2. To determine the effect of intensive lipid modification therapy on the clinically applicable hemodynamic measurements, clinical symptoms, reduction in systemic major cardiovascular events and the general quality of life of patients following PTA revascularization and stenting by assessment with Duplex ultrasound, segmental limb pressure, segmental pulse volume recording, ankle brachial indicies, treadmill walking distance, absolute claudication and quality of life questionnaires. 3. To determine the effect of intensive lipid modification therapy on lipoproteins, inflammation, and relationship to PAD progression, restenosis, and clinical events. 4. To determine the effect of intensive lipid modification therapy on thrombosis, and relationship to PAD progression, restenosis and clinical events. The association of these blood tests with clinical outcome and femoral artery image will be determined.

该子项目是利用该技术的众多研究子项目之一 资源由 NIH/NCRR 资助的中心拨款提供。子项目及 研究者 (PI) 可能已从 NIH 的另一个来源获得主要资金， 因此可以在其他 CRISP 条目中表示。列出的机构是 对于中心来说，它不一定是研究者的机构。 该研究的假设如下：联合治疗的强化调脂将抑制动脉粥样硬化的进展，并通过减少血栓形成和炎症来降低血管内支架置入术后股动脉再狭窄的发生率。 一般来说，我们将总共招募120名有症状的单腿股动脉闭塞性疾病患者。 这些患者将接受血管内支架置入术治疗，然后随机分为两个治疗组：1）标准医疗护理，包括他汀类药物治疗； 2) 使用他汀类药物加依折麦布和缓释烟酸的强化调脂医疗护理标准，以增加 HDL (>40) 并降低 LDL (<80) 和 TG (<150)。 具体来说，我们将对这些患者进行两年的跟踪研究，并研究以下具体目标： 1. 采用高分辨率 MRI 图像技术检查支架股动脉是否有支架内再狭窄以及对侧股动脉是否有动脉粥样硬化进展，以确定强化调脂治疗对动脉粥样硬化进展和股动脉再狭窄的影响。 2. 通过双工超声、节段肢体压力、分段脉搏量记录、踝臂征象、跑步机步行距离、绝对跛行和 生活质量问卷。 3. 确定强化调脂治疗对脂蛋白、炎症的影响以及与 PAD 进展、再狭窄和临床事件的关系。 4. 确定强化调脂治疗对血栓形成的影响，以及与 PAD 进展、再狭窄和临床事件的关系。 将确定这些血液测试与临床结果和股动脉图像的关联。