<International Circulation>: For my final question， you mentioned a couple and listed your preference for use in statins.  So where does fluvastatin lie on this list and why?

　　Prof. Patrick: I think fluvastatin， what is amazing about fluvastatin is that initially， the first study I did 10 or 15 years ago was to reduce restenosis.  Why? Because we did something， which for me was very convincing， the Italian people did that， they did an atherectomy which means cutting the plaque in the coronary arteries， removing the plaque by atherectomy.  That was the technique 10 to 15 years ago， and then you culture the cell of this plaque and then they were taking the plasma of the patient taking fluvastatin and putting on the culture and they were blocking the culture of the smooth muscle cell in the petri box in the culture.  So we said that’s it， let us use fluvastatin for prevention of restenosis and it had no effect.  But we were surprised to see a small but significant difference in mortality which was not even planned as a secondary end point， it was just a composite end point.  So it took the company almost three years to design specifically， a trial on mortality correctly to prove the point that statins post PCI was reducing the mortality.  We proved the point but in the meantime， the other statins have made their move.  If they had combined the two studies into one， they would have gained something more like 4 or 5 years and today I do not know what is the percent of the market which is using fluvastatin but I think it must be low， I think it must be below one digit I believe.

　　《国际循环》 :我最后一个问题是，你列举了一些关于他汀类药物使用方面的研究文献。那么，为何这些文献没有报道氟伐他汀？

　　Patrick 教授: 氟伐他汀让我惊叹的是，早在10～15年前我在如何减少血管再狭窄的研究就对氟伐他汀进行了最初分析。因为我们发现，意大利的患者接受了以切除粥样斑块为目的经皮腔内斑块旋切术。那是10～15年前的治疗技术，将术中切除下来的斑块中的细胞进行培养，并采集服用氟伐他汀患者的血清加入到培养基中，发现氟伐他汀能阻止平滑肌细胞的生长。因此，我们认为氟伐他汀虽不能阻止血管再狭窄，它可轻微降低患者的死亡率，尽管死亡率并非次要终点而是复合终点。 因此，研发公司花了近三年的时间针对患者死亡率进行了特异性研究，以证实PCI术后服用他汀类药物可以降低死亡率。 但我们同时也发现，其它他汀类药物获得进展。 如果将两项研究融合，我们可能获得4-5年的研究信息，而今，我不清楚氟伐他汀的市场占有率，应该是比较低的，我想肯定是个位数。

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