<International Circulation>: Concerning patients with vulnerable plaques how can you differentiate those patients who are more suitable for drug therapy or intervention?
Prof Eckhart Fleck: Momentarily I cannot give you a definite answer on that .I think if we see small plaques then I think we can treat that medically with statins. Experimentally, we can see that there is regression of the plaque and so one should monitor the progress of drug therapy and not do too much intervention in this area. However, one has to do intervention when there is a very thin fibrous cap or when it is already ruptured.
《国际循环》:如何确定有易损斑块的患者是适合药物治疗还是介入治疗?
Fleck教授:目前,我们还不能明确地回答这个问题。如果斑块较小的话,我想可以给予他汀治疗。研究显示,他汀能够逆转斑块,因此我们需要监测药物治疗的效果,此种情况下不大需要介入治疗。但是,如果斑块的纤维帽极薄或斑块已经破裂的话,就要做介入治疗了。
<International Circulation>: There is experimental data which showed that aggressive statin therapy not only can stabilize the plaque but can also regress it. Could you please provide a comment on this?
Prof Eckhart Fleck: There is good data that drugs that can interfere with the growth of cells such as smooth muscle cells. This can be achieved by ACE inhibitors and all types of statins. There is also good data that they can reduce the atherosclerotic process and this type of growth reduction is what we are aiming at when we are treating patients with vulnerable plaques.
《国际循环》:研究显示,强化他汀治疗不但能够稳定斑块还能逆转斑块。您怎么看这一现象?
Fleck教授:目前有充分的证据显示,抑制平滑肌细胞等细胞生长的药物(例如ACEI和他汀)能够延缓动脉粥样硬化进展。当我们治疗有易损斑块的患者时,延缓动脉粥样硬化进展正是我们的治疗目标。
Professor Eckhart Fleck serves as the Director of Internal Medicine and Cardiology at the German Heart Institute Berlin and was an invited speaker at the Great Wall International Meeting of Cardiology.