title: Relationship between advanced glycation end products and plaque progression in patients with acute coronary syndrome: the JAPAN-ACS sub-study.
abstract: BACKGROUND
  The Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome (JAPAN-ACS) trial demonstrated that early aggressive statin therapy in patients with ACS significantly reduces plaque volume (PV). Advanced glycation end products (AGEs) and the receptors of AGEs (RAGE) may lead to angiopathy in diabetes mellitus (DM) and may affect on the development of coronary PV. The present sub-study of JAPAN-ACS investigates the association between AGEs and RAGE, and PV.
  
  
  METHODS
  Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) was undertaken, followed by the initiation of statin treatment (either 4 mg/day of pitavastatin or 20 mg/day of atorvastatin), in patients with ACS. In the 208 JAPAN-ACS subjects, PV using IVUS in non-culprit segment > 5 mm proximal or distal to the culprit lesion and, serum levels of AGEs and soluble RAGE (sRAGE) were measured at baseline and 8-12 months after PCI.
  
  
  RESULTS
  At baseline, no differences in the levels of either AGEs or sRAGE were found between patients with DM and those without DM. The levels of AGEs decreased significantly with statin therapy from 8.6 ± 2.2 to 8.0 ± 2.1 U/ml (p < 0.001), whereas the levels of sRAGE did not change. There were no significant correlations between changes in PV and the changes in levels of AGEs as well as sRAGE. However, high baseline AGEs levels were significantly associated with plaque progression (odds ratio, 1.21; 95% confidence interval, 1.01 - 1.48; p = 0.044) even after adjusting for DM in multivariate logistic regression models.
  
  
  CONCLUSIONS
  High baseline AGEs levels were associated with plaque progression in the JAPAN-ACS trial. This relationship was independent of DM. These findings suggest AGEs may be related to long-term glucose control and other oxidative stresses in ACS.
  
  
  BACKGROUND
  NCT00242944.
authors.affiliation: Department of Cardiology, Juntendo University School of Medicine, Tokyo, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Fukushima
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Daida
authors.forename: Takeshi
authors.initials: T
authors.lastname: Morimoto
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Kasai
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.forename: Sho-ichi
authors.initials: S
authors.lastname: Yamagishi
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Takeuchi
authors.forename: Takafumi
authors.initials: T
authors.lastname: Hiro
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Nakagawa
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
authors.forename: Yukio
authors.initials: Y
authors.lastname: Ozaki
authors.forename: Masunori
authors.initials: M
authors.lastname: Matsuzaki
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000453:epidemiology* / Q000601:surgery; D000368:Aged; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D017127:Glycation End Products, Advanced / Q000097:blood*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods; D058226:Plaque, Atherosclerotic / Q000097:blood* / Q000453:epidemiology* / Q000601:surgery; D011446:Prospective Studies; D018084:Ultrasonography, Interventional / Q000379:methods
chemical_list: D017127:Glycation End Products, Advanced