title: Effect of pitavastatin on preventing ischemic complications with carotid artery stenting: a multicenter prospective study--EPOCH-CAS study.
abstract: OBJECTIVE
  Periprocedural ischemic stroke is one problem associated with carotid artery stenting (CAS). This study was designed to assess whether preoperative statin therapy reduces the risk of periprocedural ischemic complications with CAS.
  
  
  METHODS
  In this prospective study at 11 centers, patients with carotid artery stenosis (symptomatic ≥50%, asymptomatic ≥80%) and a high risk of carotid endarterectomy but without previous statin treatments were divided into two groups by low-density lipoprotein cholesterol (LDL-C) levels. With LDL-C ≥120 mg/dl, the pitavastatin-treated (PS) group received pitavastatin at 4 mg/day. With LDL-C <120 mg/dl, the non-PS group received no statin therapy. After 4 weeks, both groups underwent CAS. Frequencies of new ipsilateral ischemic lesions on diffusion-weighted imaging within 72 h after CAS and cerebrovascular events (transient ischemic attack, stroke, or death) within 30 days were assessed.
  
  
  RESULTS
  Among the 80 patients enrolled, 61 patients (PS group, n = 31; non-PS group, n = 30) fulfilled the inclusion criteria. New ipsilateral ischemic lesions were identified in 8 of 31 patients (25.8%) in the PS group and 16 of 30 patients (53.3%) in the non-PS group (P = 0.028). Cerebrovascular events occurred in 0 patients in the PS group and in 3 of 30 patients (10.0%) in the non-PS group (P = 0.071). Multivariate analyses demonstrated the pitavastatin treatment (β = 0.74, 95% confidence interval 0.070-1.48, P = 0.042) to be an independent factor for decreasing post-CAS ischemic lesions.
  
  
  CONCLUSIONS
  Pretreatment with pitavastatin significantly reduced the frequency of periprocedural ischemic complications with CAS.
authors: Department of Radiology and Interventional Neuroradiology, Ishinkai Yao General Hospital, 1-41 Numa Yao, Osaka, 581-0036, Japan, takayamaneuroivs@par.odn.ne.jp.
authors: Katsutoshi
authors: K
authors: Takayama
authors: Waro
authors: W
authors: Taki
authors: Naoki
authors: N
authors: Toma
authors: Ichiro
authors: I
authors: Nakahara
authors: Masayuki
authors: M
authors: Maeda
authors: Hiroshi
authors: H
authors: Tanemura
authors: Terumasa
authors: T
authors: Kuroiwa
authors: Keisuke
authors: K
authors: Imai
authors: Masahiko
authors: M
authors: Sakamoto
authors: Ichiro
authors: I
authors: Nakagawa
authors: Osamu
authors: O
authors: Masuo
authors: Kaoru
authors: K
authors: Myouchin
authors: Takeshi
authors: T
authors: Wada
authors: Hidenori
authors: H
authors: Suzuki
mesh_terms: D000368:Aged; D016893:Carotid Stenosis / Q000175:diagnosis* / Q000601:surgery*; D038524:Diffusion Magnetic Resonance Imaging; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D002546:Ischemic Attack, Transient / Q000209:etiology / Q000517:prevention & control*; D007564:Japan; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D011446:Prospective Studies; D011804:Quinolines / Q000008:administration & dosage*; D012307:Risk Factors; D015607:Stents; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008077:Lipoproteins, LDL; D011804:Quinolines; C108475:pitavastatin