Clinically evident polyvascular disease and regression of coronary atherosclerosis after intensive statin therapy in patients with acute coronary syndrome

Serial intravascular ultrasound from the Japanese assessment of pitavastatin and atorvastatin in acute coronary syndrome (JAPAN-ACS) trial

Kiyoshi Hibi, Takeshi Kimura, Kazuo Kimura, Takeshi Morimoto, Takafumi Hiro, Katsumi Miyauchi, Yoshihisa Nakagawa, Masakazu Yamagishi, Yukio Ozaki, Satoshi Saito, Tetsu Yamaguchi, Hiroyuki Daida, Masunori Matsuzaki

Research output: Contribution to journalArticle

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Abstract

Aim: To clarify whether the effects of statin treatment on plaque regression vary according to the presence or absence of polyvascular disease (PVD) in patients with acute coronary syndrome (ACS). Methods: 307 patients with ACS who underwent percutaneous coronary intervention for the culprit lesion at 33 centers were treated with atorvastatin or pitavastatin. Noncoronary atherosclerosis was defined as coexistent, clinically recognized arterial disease other than coronary artery disease (CAD) (cerebral, aortic, or lower extremity). Intravascular ultrasound (IVUS) was performed to assess non-culprit coronary atherosclerosis at baseline and at 8-12 months follow-up. Serial IVUS examinations were obtained in 252 patients. Atheroma volume and percent change in atheroma volume of the target plaque was assessed. Results: Patients of the CAD+PVD (n=19) were older (68 vs. 62 years, p=0.02), had lower low-density lipoprotein cholesterol (LDL-C) levels at baseline (116 vs. 134mg/dL, p=0.03) than those of the CAD-only group (n=233), whereas LDL-C levels at follow-up were similar (81 vs. 83mg/dL). Although the baseline plaque volume was similar in the two groups (59 vs. 57mm 3), patients of the CAD+PVD group showed milder regression of atherosclerosis than those of the CAD-only group (-8.9% vs. -18.2%, p=0.005). This difference remained significant even after adjustment for coronary risk factors including age and serum LDL-C (p=0.047). Conclusions: Statin treatment results in milder regression of coronary atherosclerosis in CAD patients with polyvascular disease compared to those with CAD only.

Original languageEnglish
Pages (from-to)743-749
Number of pages7
JournalAtherosclerosis
Volume219
Issue number2
DOIs
Publication statusPublished - 01-12-2011

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Acute Coronary Syndrome
Coronary Artery Disease
LDL Cholesterol
Therapeutics
Atherosclerotic Plaques
Atherosclerosis
Atorvastatin Calcium
pitavastatin
Percutaneous Coronary Intervention
Lower Extremity

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Hibi, Kiyoshi ; Kimura, Takeshi ; Kimura, Kazuo ; Morimoto, Takeshi ; Hiro, Takafumi ; Miyauchi, Katsumi ; Nakagawa, Yoshihisa ; Yamagishi, Masakazu ; Ozaki, Yukio ; Saito, Satoshi ; Yamaguchi, Tetsu ; Daida, Hiroyuki ; Matsuzaki, Masunori. / Clinically evident polyvascular disease and regression of coronary atherosclerosis after intensive statin therapy in patients with acute coronary syndrome : Serial intravascular ultrasound from the Japanese assessment of pitavastatin and atorvastatin in acute coronary syndrome (JAPAN-ACS) trial. In: Atherosclerosis. 2011 ; Vol. 219, No. 2. pp. 743-749.
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title = "Clinically evident polyvascular disease and regression of coronary atherosclerosis after intensive statin therapy in patients with acute coronary syndrome: Serial intravascular ultrasound from the Japanese assessment of pitavastatin and atorvastatin in acute coronary syndrome (JAPAN-ACS) trial",
abstract = "Aim: To clarify whether the effects of statin treatment on plaque regression vary according to the presence or absence of polyvascular disease (PVD) in patients with acute coronary syndrome (ACS). Methods: 307 patients with ACS who underwent percutaneous coronary intervention for the culprit lesion at 33 centers were treated with atorvastatin or pitavastatin. Noncoronary atherosclerosis was defined as coexistent, clinically recognized arterial disease other than coronary artery disease (CAD) (cerebral, aortic, or lower extremity). Intravascular ultrasound (IVUS) was performed to assess non-culprit coronary atherosclerosis at baseline and at 8-12 months follow-up. Serial IVUS examinations were obtained in 252 patients. Atheroma volume and percent change in atheroma volume of the target plaque was assessed. Results: Patients of the CAD+PVD (n=19) were older (68 vs. 62 years, p=0.02), had lower low-density lipoprotein cholesterol (LDL-C) levels at baseline (116 vs. 134mg/dL, p=0.03) than those of the CAD-only group (n=233), whereas LDL-C levels at follow-up were similar (81 vs. 83mg/dL). Although the baseline plaque volume was similar in the two groups (59 vs. 57mm 3), patients of the CAD+PVD group showed milder regression of atherosclerosis than those of the CAD-only group (-8.9{\%} vs. -18.2{\%}, p=0.005). This difference remained significant even after adjustment for coronary risk factors including age and serum LDL-C (p=0.047). Conclusions: Statin treatment results in milder regression of coronary atherosclerosis in CAD patients with polyvascular disease compared to those with CAD only.",
author = "Kiyoshi Hibi and Takeshi Kimura and Kazuo Kimura and Takeshi Morimoto and Takafumi Hiro and Katsumi Miyauchi and Yoshihisa Nakagawa and Masakazu Yamagishi and Yukio Ozaki and Satoshi Saito and Tetsu Yamaguchi and Hiroyuki Daida and Masunori Matsuzaki",
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Clinically evident polyvascular disease and regression of coronary atherosclerosis after intensive statin therapy in patients with acute coronary syndrome : Serial intravascular ultrasound from the Japanese assessment of pitavastatin and atorvastatin in acute coronary syndrome (JAPAN-ACS) trial. / Hibi, Kiyoshi; Kimura, Takeshi; Kimura, Kazuo; Morimoto, Takeshi; Hiro, Takafumi; Miyauchi, Katsumi; Nakagawa, Yoshihisa; Yamagishi, Masakazu; Ozaki, Yukio; Saito, Satoshi; Yamaguchi, Tetsu; Daida, Hiroyuki; Matsuzaki, Masunori.

In: Atherosclerosis, Vol. 219, No. 2, 01.12.2011, p. 743-749.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinically evident polyvascular disease and regression of coronary atherosclerosis after intensive statin therapy in patients with acute coronary syndrome

T2 - Serial intravascular ultrasound from the Japanese assessment of pitavastatin and atorvastatin in acute coronary syndrome (JAPAN-ACS) trial

AU - Hibi, Kiyoshi

AU - Kimura, Takeshi

AU - Kimura, Kazuo

AU - Morimoto, Takeshi

AU - Hiro, Takafumi

AU - Miyauchi, Katsumi

AU - Nakagawa, Yoshihisa

AU - Yamagishi, Masakazu

AU - Ozaki, Yukio

AU - Saito, Satoshi

AU - Yamaguchi, Tetsu

AU - Daida, Hiroyuki

AU - Matsuzaki, Masunori

PY - 2011/12/1

Y1 - 2011/12/1

N2 - Aim: To clarify whether the effects of statin treatment on plaque regression vary according to the presence or absence of polyvascular disease (PVD) in patients with acute coronary syndrome (ACS). Methods: 307 patients with ACS who underwent percutaneous coronary intervention for the culprit lesion at 33 centers were treated with atorvastatin or pitavastatin. Noncoronary atherosclerosis was defined as coexistent, clinically recognized arterial disease other than coronary artery disease (CAD) (cerebral, aortic, or lower extremity). Intravascular ultrasound (IVUS) was performed to assess non-culprit coronary atherosclerosis at baseline and at 8-12 months follow-up. Serial IVUS examinations were obtained in 252 patients. Atheroma volume and percent change in atheroma volume of the target plaque was assessed. Results: Patients of the CAD+PVD (n=19) were older (68 vs. 62 years, p=0.02), had lower low-density lipoprotein cholesterol (LDL-C) levels at baseline (116 vs. 134mg/dL, p=0.03) than those of the CAD-only group (n=233), whereas LDL-C levels at follow-up were similar (81 vs. 83mg/dL). Although the baseline plaque volume was similar in the two groups (59 vs. 57mm 3), patients of the CAD+PVD group showed milder regression of atherosclerosis than those of the CAD-only group (-8.9% vs. -18.2%, p=0.005). This difference remained significant even after adjustment for coronary risk factors including age and serum LDL-C (p=0.047). Conclusions: Statin treatment results in milder regression of coronary atherosclerosis in CAD patients with polyvascular disease compared to those with CAD only.

AB - Aim: To clarify whether the effects of statin treatment on plaque regression vary according to the presence or absence of polyvascular disease (PVD) in patients with acute coronary syndrome (ACS). Methods: 307 patients with ACS who underwent percutaneous coronary intervention for the culprit lesion at 33 centers were treated with atorvastatin or pitavastatin. Noncoronary atherosclerosis was defined as coexistent, clinically recognized arterial disease other than coronary artery disease (CAD) (cerebral, aortic, or lower extremity). Intravascular ultrasound (IVUS) was performed to assess non-culprit coronary atherosclerosis at baseline and at 8-12 months follow-up. Serial IVUS examinations were obtained in 252 patients. Atheroma volume and percent change in atheroma volume of the target plaque was assessed. Results: Patients of the CAD+PVD (n=19) were older (68 vs. 62 years, p=0.02), had lower low-density lipoprotein cholesterol (LDL-C) levels at baseline (116 vs. 134mg/dL, p=0.03) than those of the CAD-only group (n=233), whereas LDL-C levels at follow-up were similar (81 vs. 83mg/dL). Although the baseline plaque volume was similar in the two groups (59 vs. 57mm 3), patients of the CAD+PVD group showed milder regression of atherosclerosis than those of the CAD-only group (-8.9% vs. -18.2%, p=0.005). This difference remained significant even after adjustment for coronary risk factors including age and serum LDL-C (p=0.047). Conclusions: Statin treatment results in milder regression of coronary atherosclerosis in CAD patients with polyvascular disease compared to those with CAD only.

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U2 - 10.1016/j.atherosclerosis.2011.08.024

DO - 10.1016/j.atherosclerosis.2011.08.024

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