Effect of Pitavastatin on Preventing Ischemic Complications with Carotid Artery Stenting: A Multicenter Prospective Study—EPOCH-CAS Study

Katsutoshi Takayama, Waro Taki, Naoki Toma, Ichiro Nakahara, Masayuki Maeda, Hiroshi Tanemura, Terumasa Kuroiwa, Keisuke Imai, Masahiko Sakamoto, Ichiro Nakagawa, Osamu Masuo, Kaoru Myouchin, Takeshi Wada, Hidenori Suzuki

Research output: Contribution to journalArticlepeer-review

18 Citations (Scopus)

Abstract

Purpose: Periprocedural ischemic stroke is one problem associated with carotid artery stenting (CAS). This study was designed to assess whether preoperative statin therapy reduces the risk of periprocedural ischemic complications with CAS.

Methods: In this prospective study at 11 centers, patients with carotid artery stenosis (symptomatic ≥50 %, asymptomatic ≥80 %) and a high risk of carotid endarterectomy but without previous statin treatments were divided into two groups by low-density lipoprotein cholesterol (LDL-C) levels. With LDL-C ≥120 mg/dl, the pitavastatin-treated (PS) group received pitavastatin at 4 mg/day. With LDL-C <120 mg/dl, the non-PS group received no statin therapy. After 4 weeks, both groups underwent CAS. Frequencies of new ipsilateral ischemic lesions on diffusion-weighted imaging within 72 h after CAS and cerebrovascular events (transient ischemic attack, stroke, or death) within 30 days were assessed.

Results: Among the 80 patients enrolled, 61 patients (PS group, n = 31; non-PS group, n = 30) fulfilled the inclusion criteria. New ipsilateral ischemic lesions were identified in 8 of 31 patients (25.8 %) in the PS group and 16 of 30 patients (53.3 %) in the non-PS group (P = 0.028). Cerebrovascular events occurred in 0 patients in the PS group and in 3 of 30 patients (10.0 %) in the non-PS group (P = 0.071). Multivariate analyses demonstrated the pitavastatin treatment (β = 0.74, 95 % confidence interval 0.070–1.48, P = 0.042) to be an independent factor for decreasing post-CAS ischemic lesions.

Conclusion: Pretreatment with pitavastatin significantly reduced the frequency of periprocedural ischemic complications with CAS.

Original languageEnglish
Pages (from-to)1436-1443
Number of pages8
JournalCardioVascular and Interventional Radiology
Volume37
Issue number6
DOIs
Publication statusPublished - 12-2014
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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