Details

Autor(en) / Beteiligte

• Koichiro Fujisue
• Kenshi Yamanaga
• Suguru Nagamatsu
• Hideki Shimomura
• Takuro Yamashita
• Koichi Nakao
• Sunao Nakamura
• Masaharu Ishihara
• Kunihiko Matsui
• Naritsugu Sakaino
• Takashi Miyazaki
• Nobuyasu Yamamoto
• Shunichi Koide
• Toshiyuki Matsumura
• Kazuteru Fujimoto
• Ryusuke Tsunoda
• Yasuhiro Morikami
• Koushi Matsuyama
• Shuichi Oshima
• Kenji Sakamoto
• Yasuhiro Izumiya
• Koichi Kaikita
• Seiji Hokimoto
• Hisao Ogawa
• Kenichi Tsujita

Titel

Effects of Statin Plus Ezetimibe on Coronary Plaques in Acute Coronary Syndrome Patients with Diabetes Mellitus : Sub-Analysis of PRECISE-IVUS Trial

Ist Teil von

• Journal of Atherosclerosis and Thrombosis, 2021, Vol.28 (2), p.181-193

Ort / Verlag

Japan Atherosclerosis Society

Erscheinungsjahr

2021

Link zum Volltext

Quelle

Elektronische Zeitschriftenbibliothek - Freely accessible e-journals

Beschreibungen/Notizen

• [Aim] : Coronary plaque regression is weak in acute coronary syndrome (ACS) patients with diabetes mellitus (DM). We evaluated whether dual lipid-lowering therapy (DLLT) with ezetimibe and atorvastatin attenuates coronary plaques in ACS patients with DM. [Methods] : The prospective, randomized controlled, multicenter PRECISE-IVUS (Plaque Regression with Cholesterol Absorption Inhibitor or Synthesis Inhibitor Evaluated by Intravascular Ultrasound) trial assigned 246 patients undergoing percutaneous coronary intervention to DLLT or atorvastatin monotherapy and evaluated IVUS-derived changes in percent atheroma volume (ΔPAV), at baseline and 9-12-month follow-up, in 126 ACS cases, including 25 DM patients. The atorvastatin dose was up-titrated to achieve low-density lipoprotein cholesterol (LDL-C) <70 mg/dL. [Results] : In DM patients, the monotherapy group (n = 13) and the DLLT group (n = 12) showed a similar prevalence of coronary risks and baseline lipid profiles. During the study, the change in LDL-C level was similar between DM and non-DM patients. Compared with non-DM patients, DM patients showed weaker regression of ΔPAV by DLLT than those who underwent monotherapy (DM : -2.77 +- 3.47% vs. -0.77 +- 2.51%, P = 0.11 ; non-DM : -2.01 +- 3.36% vs. -0.08 +- 2.66%, P = 0.008). The change in LDL-C level was not correlated with ΔPAV in non-DM patients, but there was significant correlation between the change in LDL-C level and ΔPAV in DM patients (r = 0.52, P = 0.008). [Conclusions] : ACS patients with DM showed weaker coronary plaque regression than their counterparts. A significant correlation between the change in LDL-C level and ΔPAV in DM patients suggested that more intensive lipid-lowering therapy is required in ACS patients with DM.