Effects of ezetimibe-statin combination therapy on coronary atherosclerosis in acute coronary syndrome

Ezetimibe-ACS Investigators

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: The results of previous clinical trials on the effects of ezetimibe-statin combination therapy on atherosclerosis are inconsistent, and the anti-atherosclerotic effect of ezetimibe remains controversial. Methods and Results: We conducted a prospective, randomized open-label study at 10 centers. One hundred and twenty-eight statin-naïve patients with acute coronary syndrome (ACS) undergoing intravascular ultrasound (IVUS)-guided percutaneous coronary intervention were randomized to receive either 2 mg/day pitavastatin plus 10 mg/day ezetimibe, or 2 mg/day pitavastatin. One hundred and 3 patients had evaluable IVUS of non-culprit coronary lesions at baseline and at follow-up. The primary endpoint was the percentage change in non-culprit coronary plaque volume (PV) and lipid PV on integrated backscatter IVUS. Mean low-density lipoprotein cholesterol was reduced from 123 mg/dL to 64 mg/dL in the combination therapy group (n=50) and 126 mg/dL to 87 mg/dL in the statin alone group (n=53; between-group difference, 16.9%, P<0.0001). The percent change in PV was −5.1% in the combination therapy group and −6.2% in the statin alone group (P=0.66), although both groups had reduction of PV compared with baseline (both P<0.01). The percent change in lipid PV did not differ between the groups (4.3 vs. −3.0%, P=0.37). Conclusions: In statin-naïve patients with ACS, combined therapy with ezetimibe and statin did not result in a significant change in coronary plaque regression or tissue component compared with statin alone.

Original languageEnglish
Pages (from-to)757-766
Number of pages10
JournalCirculation Journal
Volume82
Issue number3
DOIs
Publication statusPublished - 01-01-2018

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Acute Coronary Syndrome
Coronary Artery Disease
Group Psychotherapy
Therapeutics
Lipids
Percutaneous Coronary Intervention
Ezetimibe
LDL Cholesterol
Atherosclerosis
Clinical Trials

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

@article{89ebbd85894d40e19ec2d1e39832f291,
title = "Effects of ezetimibe-statin combination therapy on coronary atherosclerosis in acute coronary syndrome",
abstract = "Background: The results of previous clinical trials on the effects of ezetimibe-statin combination therapy on atherosclerosis are inconsistent, and the anti-atherosclerotic effect of ezetimibe remains controversial. Methods and Results: We conducted a prospective, randomized open-label study at 10 centers. One hundred and twenty-eight statin-na{\"i}ve patients with acute coronary syndrome (ACS) undergoing intravascular ultrasound (IVUS)-guided percutaneous coronary intervention were randomized to receive either 2 mg/day pitavastatin plus 10 mg/day ezetimibe, or 2 mg/day pitavastatin. One hundred and 3 patients had evaluable IVUS of non-culprit coronary lesions at baseline and at follow-up. The primary endpoint was the percentage change in non-culprit coronary plaque volume (PV) and lipid PV on integrated backscatter IVUS. Mean low-density lipoprotein cholesterol was reduced from 123 mg/dL to 64 mg/dL in the combination therapy group (n=50) and 126 mg/dL to 87 mg/dL in the statin alone group (n=53; between-group difference, 16.9{\%}, P<0.0001). The percent change in PV was −5.1{\%} in the combination therapy group and −6.2{\%} in the statin alone group (P=0.66), although both groups had reduction of PV compared with baseline (both P<0.01). The percent change in lipid PV did not differ between the groups (4.3 vs. −3.0{\%}, P=0.37). Conclusions: In statin-na{\"i}ve patients with ACS, combined therapy with ezetimibe and statin did not result in a significant change in coronary plaque regression or tissue component compared with statin alone.",
author = "{Ezetimibe-ACS Investigators} and Kiyoshi Hibi and Shinjo Sonoda and Masanori Kawasaki and Yutaka Otsuji and Toyoaki Murohara and Hideki Ishii and Katsuhiko Sato and Ryoji Koshida and Yukio Ozaki and Yukio Ozaki and Yoshihiro Morino and Tadashi Miyamoto and Tetsuya Amano and Satoshi Morita and Ken Kozuma and Kazuo Kimura and Hisayoshi Fujiwara",
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doi = "10.1253/circj.CJ-17-0598",
language = "English",
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Effects of ezetimibe-statin combination therapy on coronary atherosclerosis in acute coronary syndrome. / Ezetimibe-ACS Investigators.

In: Circulation Journal, Vol. 82, No. 3, 01.01.2018, p. 757-766.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effects of ezetimibe-statin combination therapy on coronary atherosclerosis in acute coronary syndrome

AU - Ezetimibe-ACS Investigators

AU - Hibi, Kiyoshi

AU - Sonoda, Shinjo

AU - Kawasaki, Masanori

AU - Otsuji, Yutaka

AU - Murohara, Toyoaki

AU - Ishii, Hideki

AU - Sato, Katsuhiko

AU - Koshida, Ryoji

AU - Ozaki, Yukio

AU - Ozaki, Yukio

AU - Morino, Yoshihiro

AU - Miyamoto, Tadashi

AU - Amano, Tetsuya

AU - Morita, Satoshi

AU - Kozuma, Ken

AU - Kimura, Kazuo

AU - Fujiwara, Hisayoshi

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: The results of previous clinical trials on the effects of ezetimibe-statin combination therapy on atherosclerosis are inconsistent, and the anti-atherosclerotic effect of ezetimibe remains controversial. Methods and Results: We conducted a prospective, randomized open-label study at 10 centers. One hundred and twenty-eight statin-naïve patients with acute coronary syndrome (ACS) undergoing intravascular ultrasound (IVUS)-guided percutaneous coronary intervention were randomized to receive either 2 mg/day pitavastatin plus 10 mg/day ezetimibe, or 2 mg/day pitavastatin. One hundred and 3 patients had evaluable IVUS of non-culprit coronary lesions at baseline and at follow-up. The primary endpoint was the percentage change in non-culprit coronary plaque volume (PV) and lipid PV on integrated backscatter IVUS. Mean low-density lipoprotein cholesterol was reduced from 123 mg/dL to 64 mg/dL in the combination therapy group (n=50) and 126 mg/dL to 87 mg/dL in the statin alone group (n=53; between-group difference, 16.9%, P<0.0001). The percent change in PV was −5.1% in the combination therapy group and −6.2% in the statin alone group (P=0.66), although both groups had reduction of PV compared with baseline (both P<0.01). The percent change in lipid PV did not differ between the groups (4.3 vs. −3.0%, P=0.37). Conclusions: In statin-naïve patients with ACS, combined therapy with ezetimibe and statin did not result in a significant change in coronary plaque regression or tissue component compared with statin alone.

AB - Background: The results of previous clinical trials on the effects of ezetimibe-statin combination therapy on atherosclerosis are inconsistent, and the anti-atherosclerotic effect of ezetimibe remains controversial. Methods and Results: We conducted a prospective, randomized open-label study at 10 centers. One hundred and twenty-eight statin-naïve patients with acute coronary syndrome (ACS) undergoing intravascular ultrasound (IVUS)-guided percutaneous coronary intervention were randomized to receive either 2 mg/day pitavastatin plus 10 mg/day ezetimibe, or 2 mg/day pitavastatin. One hundred and 3 patients had evaluable IVUS of non-culprit coronary lesions at baseline and at follow-up. The primary endpoint was the percentage change in non-culprit coronary plaque volume (PV) and lipid PV on integrated backscatter IVUS. Mean low-density lipoprotein cholesterol was reduced from 123 mg/dL to 64 mg/dL in the combination therapy group (n=50) and 126 mg/dL to 87 mg/dL in the statin alone group (n=53; between-group difference, 16.9%, P<0.0001). The percent change in PV was −5.1% in the combination therapy group and −6.2% in the statin alone group (P=0.66), although both groups had reduction of PV compared with baseline (both P<0.01). The percent change in lipid PV did not differ between the groups (4.3 vs. −3.0%, P=0.37). Conclusions: In statin-naïve patients with ACS, combined therapy with ezetimibe and statin did not result in a significant change in coronary plaque regression or tissue component compared with statin alone.

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U2 - 10.1253/circj.CJ-17-0598

DO - 10.1253/circj.CJ-17-0598

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VL - 82

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JF - Circulation Journal

SN - 1346-9843

IS - 3

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