More intensive lipid lowering is associated with regression of coronary atherosclerosis in diabetic patients with acute coronary syndrome - sub-analysis of JAPAN-ACS study

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

研究成果: ジャーナルへの寄稿学術論文査読

50 被引用数 (Scopus)

抄録

Aim: We have shown that aggressive lipid lowering by pitavastatin and atorvastatin results in marked regression of atherosclerotic coronary lesions after acute coronary syndrome (ACS). The purpose of this study was to address the association of lipid levels after statin therapy with regression of atherosclerotic coronary lesions and major cardiovascular events in patients after ACS. Methods: JAPAN-ACS is a prospective, randomized open-label study performed at 33 centers in Japan. Patients with ACS undergoing intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) were randomly assigned to receive either 4 mg/day pitavastatin or 20 mg/day atorvastatin within 72 hours after PCI. IVUS image was obtained in 251 patients, including 73 diabetic patients. Lipid profiles at the end of the study were divided into quartiles and the association with the percent change in non-culprit coronary plaque volume (PV) was assessed in total and diabetic patients. We also studied whether baseline and follow-up levels of HDL-cholesterol are associated with restenosis after PCI. Results: Decreasing LDL-cholesterol, non-HDL-cholesterol, LDL-C/HDL-C ratio, apolipoprotein B quartiles were associated with a progressively smaller plaque burden in total and diabetic patients. In diabetic patients, further reduction of these parameters was associated with a significantly greater reduction in PV. We also found that patients with lower HDL-cholesterol had a significantly higher incidence of target lesion revascularization. Conclusions: Early intensive statin therapy in patients after ACS results in remarkable regression of coronary PV. Diabetic patients can have a benefit with more intensive therapy to achieve a lower target level in Japanese.

本文言語英語
ページ(範囲)1096-1107
ページ数12
ジャーナルJournal of atherosclerosis and thrombosis
17
10
DOI
出版ステータス出版済み - 2010
外部発表はい

All Science Journal Classification (ASJC) codes

  • 内科学
  • 循環器および心血管医学
  • 生化学、医学

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