Reverse vessel remodeling but not coronary plaque regression could predict future cardiovascular events in acs patients with intensive statin therapy - The extended JAPAN-ACS study -

Katsumi Miyauchi, Hiroyuki Daida, Takeshi Morimoto, Takafumi Hiro, Takeshi Kimura, Yoshihisa Nakagawa, Masakazu Yamagishi, Yukio Ozaki, Kazushige Kadota, Kazuo Kimura, Atsushi Hirayama, Kazumi Kimura, Yasuhiro Hasegawa, Shinichiro Uchiyama, Masunori Matsuzaki

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Background: The JAPAN-ACS study demonstrated that statins significantly reduced coronary plaque volume in patients with acute coronary syndrome (ACS). The clinical implications of plaque regression for clinical outcomes in ACS patients has not been established. The Extended JAPAN-ACS study was conducted to evaluate the relationship between coronary plaque regression and long-term clinical outcome, and to explore the factors associated with cardiovascular events. Methods and Results: Patients with intravascular ultrasound (IVUS) data at both enrollment and follow-up in the JAPAN-ACS study were enrolled and observed for at least 3 years. Patients were divided into lesser and greater coronary plaque regression groups. The primary endpoint was defined as a composite of the following events: cardiovascular death, nonfatal myocardial infarction, nonfatal cerebral infarction, and unstable angina. The median value of the percent change in plaque volume, 18.0%, was used as a cutoff point. There were 4 primary events (3.4%) in the lesser regression group, and 2 events (1.7%) in the greater regression group (P=0.4). Cumulative secondary cardiovascular events did not differ between the 2 groups. Multivariate analysis identified the high-density lipoprotein cholesterol (HDL-C) at baseline and the % change of the external elastic membrane volume as independent risk factors of cardiovascular events. Conclusions: Coronary plaque regression induced by an intensive statin regimen did not predict future cardiovascular events in ACS patients. Rather, the baseline HDL-C level and reverse vessel remodeling might serve as predictors for cardiovascular events.

Original languageEnglish
Pages (from-to)825-832
Number of pages8
JournalCirculation Journal
Volume76
Issue number4
DOIs
Publication statusPublished - 30-03-2012

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Acute Coronary Syndrome
HDL Cholesterol
Therapeutics
Unstable Angina
Cerebral Infarction
Multivariate Analysis
Myocardial Infarction
Membranes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Miyauchi, Katsumi ; Daida, Hiroyuki ; Morimoto, Takeshi ; Hiro, Takafumi ; Kimura, Takeshi ; Nakagawa, Yoshihisa ; Yamagishi, Masakazu ; Ozaki, Yukio ; Kadota, Kazushige ; Kimura, Kazuo ; Hirayama, Atsushi ; Kimura, Kazumi ; Hasegawa, Yasuhiro ; Uchiyama, Shinichiro ; Matsuzaki, Masunori. / Reverse vessel remodeling but not coronary plaque regression could predict future cardiovascular events in acs patients with intensive statin therapy - The extended JAPAN-ACS study -. In: Circulation Journal. 2012 ; Vol. 76, No. 4. pp. 825-832.
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title = "Reverse vessel remodeling but not coronary plaque regression could predict future cardiovascular events in acs patients with intensive statin therapy - The extended JAPAN-ACS study -",
abstract = "Background: The JAPAN-ACS study demonstrated that statins significantly reduced coronary plaque volume in patients with acute coronary syndrome (ACS). The clinical implications of plaque regression for clinical outcomes in ACS patients has not been established. The Extended JAPAN-ACS study was conducted to evaluate the relationship between coronary plaque regression and long-term clinical outcome, and to explore the factors associated with cardiovascular events. Methods and Results: Patients with intravascular ultrasound (IVUS) data at both enrollment and follow-up in the JAPAN-ACS study were enrolled and observed for at least 3 years. Patients were divided into lesser and greater coronary plaque regression groups. The primary endpoint was defined as a composite of the following events: cardiovascular death, nonfatal myocardial infarction, nonfatal cerebral infarction, and unstable angina. The median value of the percent change in plaque volume, 18.0{\%}, was used as a cutoff point. There were 4 primary events (3.4{\%}) in the lesser regression group, and 2 events (1.7{\%}) in the greater regression group (P=0.4). Cumulative secondary cardiovascular events did not differ between the 2 groups. Multivariate analysis identified the high-density lipoprotein cholesterol (HDL-C) at baseline and the {\%} change of the external elastic membrane volume as independent risk factors of cardiovascular events. Conclusions: Coronary plaque regression induced by an intensive statin regimen did not predict future cardiovascular events in ACS patients. Rather, the baseline HDL-C level and reverse vessel remodeling might serve as predictors for cardiovascular events.",
author = "Katsumi Miyauchi and Hiroyuki Daida and Takeshi Morimoto and Takafumi Hiro and Takeshi Kimura and Yoshihisa Nakagawa and Masakazu Yamagishi and Yukio Ozaki and Kazushige Kadota and Kazuo Kimura and Atsushi Hirayama and Kazumi Kimura and Yasuhiro Hasegawa and Shinichiro Uchiyama and Masunori Matsuzaki",
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month = "3",
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doi = "10.1253/circj.CJ-12-0135",
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Miyauchi, K, Daida, H, Morimoto, T, Hiro, T, Kimura, T, Nakagawa, Y, Yamagishi, M, Ozaki, Y, Kadota, K, Kimura, K, Hirayama, A, Kimura, K, Hasegawa, Y, Uchiyama, S & Matsuzaki, M 2012, 'Reverse vessel remodeling but not coronary plaque regression could predict future cardiovascular events in acs patients with intensive statin therapy - The extended JAPAN-ACS study -', Circulation Journal, vol. 76, no. 4, pp. 825-832. https://doi.org/10.1253/circj.CJ-12-0135

Reverse vessel remodeling but not coronary plaque regression could predict future cardiovascular events in acs patients with intensive statin therapy - The extended JAPAN-ACS study -. / Miyauchi, Katsumi; Daida, Hiroyuki; Morimoto, Takeshi; Hiro, Takafumi; Kimura, Takeshi; Nakagawa, Yoshihisa; Yamagishi, Masakazu; Ozaki, Yukio; Kadota, Kazushige; Kimura, Kazuo; Hirayama, Atsushi; Kimura, Kazumi; Hasegawa, Yasuhiro; Uchiyama, Shinichiro; Matsuzaki, Masunori.

In: Circulation Journal, Vol. 76, No. 4, 30.03.2012, p. 825-832.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Reverse vessel remodeling but not coronary plaque regression could predict future cardiovascular events in acs patients with intensive statin therapy - The extended JAPAN-ACS study -

AU - Miyauchi, Katsumi

AU - Daida, Hiroyuki

AU - Morimoto, Takeshi

AU - Hiro, Takafumi

AU - Kimura, Takeshi

AU - Nakagawa, Yoshihisa

AU - Yamagishi, Masakazu

AU - Ozaki, Yukio

AU - Kadota, Kazushige

AU - Kimura, Kazuo

AU - Hirayama, Atsushi

AU - Kimura, Kazumi

AU - Hasegawa, Yasuhiro

AU - Uchiyama, Shinichiro

AU - Matsuzaki, Masunori

PY - 2012/3/30

Y1 - 2012/3/30

N2 - Background: The JAPAN-ACS study demonstrated that statins significantly reduced coronary plaque volume in patients with acute coronary syndrome (ACS). The clinical implications of plaque regression for clinical outcomes in ACS patients has not been established. The Extended JAPAN-ACS study was conducted to evaluate the relationship between coronary plaque regression and long-term clinical outcome, and to explore the factors associated with cardiovascular events. Methods and Results: Patients with intravascular ultrasound (IVUS) data at both enrollment and follow-up in the JAPAN-ACS study were enrolled and observed for at least 3 years. Patients were divided into lesser and greater coronary plaque regression groups. The primary endpoint was defined as a composite of the following events: cardiovascular death, nonfatal myocardial infarction, nonfatal cerebral infarction, and unstable angina. The median value of the percent change in plaque volume, 18.0%, was used as a cutoff point. There were 4 primary events (3.4%) in the lesser regression group, and 2 events (1.7%) in the greater regression group (P=0.4). Cumulative secondary cardiovascular events did not differ between the 2 groups. Multivariate analysis identified the high-density lipoprotein cholesterol (HDL-C) at baseline and the % change of the external elastic membrane volume as independent risk factors of cardiovascular events. Conclusions: Coronary plaque regression induced by an intensive statin regimen did not predict future cardiovascular events in ACS patients. Rather, the baseline HDL-C level and reverse vessel remodeling might serve as predictors for cardiovascular events.

AB - Background: The JAPAN-ACS study demonstrated that statins significantly reduced coronary plaque volume in patients with acute coronary syndrome (ACS). The clinical implications of plaque regression for clinical outcomes in ACS patients has not been established. The Extended JAPAN-ACS study was conducted to evaluate the relationship between coronary plaque regression and long-term clinical outcome, and to explore the factors associated with cardiovascular events. Methods and Results: Patients with intravascular ultrasound (IVUS) data at both enrollment and follow-up in the JAPAN-ACS study were enrolled and observed for at least 3 years. Patients were divided into lesser and greater coronary plaque regression groups. The primary endpoint was defined as a composite of the following events: cardiovascular death, nonfatal myocardial infarction, nonfatal cerebral infarction, and unstable angina. The median value of the percent change in plaque volume, 18.0%, was used as a cutoff point. There were 4 primary events (3.4%) in the lesser regression group, and 2 events (1.7%) in the greater regression group (P=0.4). Cumulative secondary cardiovascular events did not differ between the 2 groups. Multivariate analysis identified the high-density lipoprotein cholesterol (HDL-C) at baseline and the % change of the external elastic membrane volume as independent risk factors of cardiovascular events. Conclusions: Coronary plaque regression induced by an intensive statin regimen did not predict future cardiovascular events in ACS patients. Rather, the baseline HDL-C level and reverse vessel remodeling might serve as predictors for cardiovascular events.

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U2 - 10.1253/circj.CJ-12-0135

DO - 10.1253/circj.CJ-12-0135

M3 - Article

C2 - 22451449

AN - SCOPUS:84858964598

VL - 76

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EP - 832

JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

IS - 4

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