title: Clustering of metabolic syndrome components attenuates coronary plaque regression during intensive statin therapy in patients with acute coronary syndrome: the JAPAN-ACS subanalysis study.
abstract: BACKGROUND
  The JAPAN-ACS (Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome) trial showed that intensive statin therapy could induce significant coronary plaque regression in acute coronary syndrome (ACS). We evaluated the impact of metabolic syndrome (MetS) and its components on coronary plaque regression in the JAPAN-ACS patients.
  
  
  RESULTS
  Serial intravascular ultrasound measurements over 8-12 months were performed in 242 ACS patients receiving pitavastatin or atorvastatin. Patients were divided into groups according to the presence of MetS or the number of MetS components. Although the percent change in plaque volume (%PV) was not significantly different between the MetS (n=119) and non-MetS (n=123) groups (P=0.50), it was significantly associated with an increasing number of MetS components (component 0: -24.0%, n=7; components 1: -20.8%, n=31; components 2: -16.1%, n=69; components 3: -18.7%, n=83; components 4: -13.5%, n=52; P=0.037 for trend). The percent change in body mass index (%BMI) significantly correlated with %PV (r=0.15, P=0.021), especially in the MetS components 4 group (r=0.35, P=0.017). In addition, %BMI was an independent predictor of plaque regression after adjustment for the changes of low- and high-density lipoprotein cholesterol, triglycerides and HbA(1c).
  
  
  CONCLUSIONS
  The clustering of MetS components, but not the presence of MetS itself, could attenuate coronary plaque regression during intensive statin therapy in ACS patients. Therefore, to achieve a greater degree of plaque regression, it is necessary to treat to each MetS component and use lifestyle modification.
authors.affiliation: Department of Cardiology, Aichi Medical University, Nagakute, Japan. h0914@aichi-med-u.ac.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takashima
authors.forename: Yukio
authors.initials: Y
authors.lastname: Ozaki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Morimoto
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
authors.forename: Takafumi
authors.initials: T
authors.lastname: Hiro
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Nakagawa
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
authors.forename: Tomofumi
authors.initials: T
authors.lastname: Mizuno
authors.forename: Kenji
authors.initials: K
authors.lastname: Asai
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Kuroda
authors.forename: Takashi
authors.initials: T
authors.lastname: Kosaka
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kuhara
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Kurita
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Maeda
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Amano
authors.forename: Masunori
authors.initials: M
authors.lastname: Matsuzaki
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D000368:Aged; D000704:Analysis of Variance; D000069059:Atorvastatin; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D016009:Chi-Square Distribution; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007564:Japan / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000453:epidemiology* / Q000628:therapy; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D058226:Plaque, Atherosclerotic; D011446:Prospective Studies; D011758:Pyrroles / Q000627:therapeutic use*; D011804:Quinolines / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D014280:Triglycerides / Q000097:blood; D018084:Ultrasonography, Interventional
chemical_list: D000069059:Atorvastatin; D015415:Biomarkers; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006442:Glycated Hemoglobin; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D011804:Quinolines; D014280:Triglycerides; C517652:hemoglobin A1c protein, human; C108475:pitavastatin