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

フォーマット:

論文

責任表示:

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

言語:

英語

出版情報:

Japan Atherosclerosis Society = 日本動脈硬化学会, 2010-10-27

著者名:

Arai, Hidenori

Hiro, Takafumi

Kimura, Takeshi

Morimoto, Takeshi

Miyauchi, Katsumi

Nakagawa, Yoshihisa

Yamagishi, Masakazu

Ozaki, Yukio

Kimura, Kazuo

Saito, Satoshi

Yamaguchi, Tetsu

Daida, Hiroyuki

Matsuzaki, Masunori

山岸, 正和

続きを見る

掲載情報:

Journal of Atherosclerosis and Thrombosis

ISSN:

1340-3478      

巻:

17

通号:

10

開始ページ:

1096

終了ページ:

1107

バージョン:

publisher

概要:

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 associatio … n 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.<br />出版者照会後に全文公開 続きを見る

URL:

http://hdl.handle.net/2297/48534