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 - Sata, Masataka
AU - Morino, Yoshihiro
AU - Miyamoto, Tadashi
AU - Amano, Tetsuya
AU - Morita, Satoshi
AU - Kozuma, Ken
AU - Kimura, Kazuo
AU - Fujiwara, Hisayoshi
N1 - Funding Information:
This work was supported in part by a grant from Japan Heart Foundation (12090006). The funding agency had no role in the design or conduct of the study, in the collection, analysis, or interpretation of the data, or in the preparation, review, or approval of the manuscript.
Publisher Copyright:
© 2018, Japanese Circulation Society. All rights reserved.
PY - 2018
Y1 - 2018
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
M3 - Article
C2 - 29212965
AN - SCOPUS:85042510747
VL - 82
SP - 757
EP - 766
JO - Circulation Journal
JF - Circulation Journal
SN - 1346-9843
IS - 3
ER -