Effect of pravastatin on malondialdehyde-modified low-density lipoprotein levels and coronary plaque regression as determined by three-dimensional intravascular ultrasound.
We hypothesized that a reduction in atherogenic malondialdehyde-modified low-density lipoprotein (MDA-LDL) levels, which may antagonize the action of atheroprotective high-density lipoprotein cholesterol, leads to coronary plaque regression. This study investigated the effects of pravastatin on the serum levels of MDA-LDL and coronary atherosclerosis. In a 6-month prospective study, 75 patients with stable coronary artery disease were randomly assigned to a pravastatin-treatment group (n = 52) or a control group (n = 23). Volumetric analyses were performed in matched coronary artery segments by 3-dimensional intravascular ultrasound. Pravastatin therapy for 6 months resulted in a decrease in coronary plaque volume (14.4%, p <0.0001) and a corresponding reduction in serum MDA-LDL levels (12.7%, p = 0.0001). In the pravastatin treatment group, the percentage of change in plaque volume correlated with changes in the MDA-LDL and high-density lipoprotein cholesterol levels (r = 0.52 and -0.55, respectively, p <0.0001) but not with the changes in any other lipid levels. Multivariate regression analysis revealed that a reduced MDA-LDL level is an independent predictor of plaque regression, as was an increase in high-density lipoprotein cholesterol. In conclusion, these results suggest that the reduction in the MDA-LDL levels induced by pravastatin may serve as a novel marker of coronary atherosclerosis regression.
Tani
Shigemasa
S
Department of Cardiology, Nihon University Surugadai Hospital, Tokyo, Japan. tanishigem@yahoo.co.jp
Watanabe
Ikuyoshi
I
Anazawa
Takeo
T
Kawamata
Hirofumi
H
Tachibana
Eizo
E
Furukawa
Kiyotaka
K
Sato
Yuichi
Y
Nagao
Ken
K
Kanmatsuse
Katsuo
K
Kushiro
Toshio
T
D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D002784:Cholesterol / Q000097:blood; D003327:Coronary Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy*; D003920:Diabetes Mellitus; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008315:Malondialdehyde / Q000031:analogs & derivatives* / Q000097:blood; D008875:Middle Aged; D017035:Pravastatin / Q000627:therapeutic use*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D014463:Ultrasonography
D000924:Anticholesteremic Agents; D008077:Lipoproteins, LDL; C502964:malondialdehyde-low density lipoprotein, mouse; D008315:Malondialdehyde; D002784:Cholesterol; D017035:Pravastatin