Rapid stabilization of vulnerable carotid plaque within 1 month of pitavastatin treatment in patients with acute coronary syndrome.
We determined time course of stabilization of echolucent carotid plaques by statin therapy in patients with acute coronary syndrome (ACS). Treatment with 4 mg/d pitavastatin (n = 33) or placebo (n = 32) was initiated within 3 days after onset of ACS in 65 patients with echolucent carotid plaque. Vulnerable carotid plaques were assessed by measuring plaque echolucency using carotid ultrasound with integrated backscatter (IBS) analysis before and 1 month after treatment in all patients. The calibrated IBS value (intima-media IBS value minus adventia IBS) of vulnerable carotid plaques favorably changed at 1 month after treatment in both groups, but the echolucency at 1 month improved more in the pitavastatin than in the placebo group (pitavastatin group: -18.7 +/- 3.3 dB at pretreatment versus -12.7 +/- 2.3 dB at 1 month *P < 0.001; placebo: -19.0 +/- 3.5 dB versus -16.9 +/- 3.2 dB, P < 0.05, *P < 0.01 versus the value at 1 month in placebo group). Levels of CRP, VEGF, and TNFalpha at 1 month were significantly lower in pitavastatin than placebo group. In conclusion, pitavastatin improved carotid plaque echolucency within 1 month of therapy in patients with ACS, in association with decrease in the inflammatory biomarkers related to vulnerable plaques.
Nakamura
Takamitsu
T
Department of Internal Medicine II, University of Yamanashi, Faculty of Medicine, Chuo, Japan.
Obata
Jun-Ei
JE
Kitta
Yoshinobu
Y
Takano
Hajime
H
Kobayashi
Tsuyoshi
T
Fujioka
Daisuke
D
Saito
Yukio
Y
Kodama
Yasushi
Y
Kawabata
Kenichi
K
Mende
Akira
A
Yano
Toshiaki
T
Hirano
Mitsumasa
M
Sano
Keita
K
Nakamura
Kazuto
K
Kugiyama
Kiyotaka
K
D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000188:drug therapy*; D002097:C-Reactive Protein / Q000378:metabolism; D016893:Carotid Stenosis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011804:Quinolines / Q000627:therapeutic use*; D013997:Time Factors; D014280:Triglycerides / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism; D014463:Ultrasonography; D042461:Vascular Endothelial Growth Factor A / Q000378:metabolism
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011804:Quinolines; D014280:Triglycerides; D014409:Tumor Necrosis Factor-alpha; D042461:Vascular Endothelial Growth Factor A; D002097:C-Reactive Protein; C108475:pitavastatin