title: Low serum docosahexaenoic acid is associated with progression of coronary atherosclerosis in statin-treated patients with diabetes mellitus: results of the treatment with statin on atheroma regression evaluated by intravascular ultrasound with virtual histology (TRUTH) study.
abstract: BACKGROUND
  Diabetes mellitus (DM) accelerates plaque progression despite the use of statin therapy. The purpose of the present study was to evaluate the determinants of atheroma progression in statin-treated patients with DM.
  
  
  METHODS
  Coronary atherosclerosis in nonculprit lesions in a vessel undergoing percutaneous coronary intervention (PCI) was evaluated using virtual histology intravascular ultrasound. The study included 50 patients with DM who had been taking statin therapy for 8 months at the time of PCI.
  
  
  RESULTS
  Twenty-six patients (52%) showed atheroma progression (progressors) and the remaining 24 patients (48%) showed atheroma regression (regressors) after 8 months of follow-up. Fewer progressors than regressors received intensive lipid-lowering therapy with pitavastatin (31% vs. 50%, p = 0.17) and the frequency of insulin use was higher in progressors (31% vs. 13%, p = 0.18). However, neither of these differences reached statistical significance. Risk factor control at baseline and at the 8-month follow-up did not differ between the 2 groups except for serum levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). Univariate regression analysis showed that serum EPA (r = -0.317, p = 0.03) and DHA (r = -0.353, p = 0.02) negatively correlated with atheroma progression. Multivariate stepwise regression analysis showed that low serum DHA and pravastatin use were significant independent predictors for atheroma progression during statin therapy (DHA: β = -0.414, type of statin: β = -0.287, p = 0.001).
  
  
  CONCLUSIONS
  Low serum DHA is associated with progression of coronary atherosclerosis in statin-treated patients with DM.
  
  
  BACKGROUND
  UMIN Clinical Trials Registry, UMIN ID: C000000311.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Yokohama Sakae Kyosai Hospital, Federation of National Public Service Personnel Mutual Associations, 132 Katsura-cho, Sakae-ku, Yokohama 247-8581, Japan. nozue2493@yahoo.co.jp.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Nozue
authors.forename: Shingo
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Shinichi
authors.initials: S
authors.lastname: Tohyama
authors.forename: Kazuki
authors.initials: K
authors.lastname: Fukui
authors.forename: Shigeo
authors.initials: S
authors.lastname: Umezawa
authors.forename: Yuko
authors.initials: Y
authors.lastname: Onishi
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Kunishima
authors.forename: Akira
authors.initials: A
authors.lastname: Sato
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Nozato
authors.forename: Shogo
authors.initials: S
authors.lastname: Miyake
authors.forename: Youichi
authors.initials: Y
authors.lastname: Takeyama
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Morino
authors.forename: Takao
authors.initials: T
authors.lastname: Yamauchi
authors.forename: Toshiya
authors.initials: T
authors.lastname: Muramatsu
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Hibi
authors.forename: Mitsuyasu
authors.initials: M
authors.lastname: Terashima
authors.forename: Ichiro
authors.initials: I
authors.lastname: Michishita
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000188:drug therapy; D003920:Diabetes Mellitus / Q000097:blood* / Q000000981:diagnostic imaging / Q000188:drug therapy; D018450:Disease Progression; D004281:Docosahexaenoic Acids / Q000097:blood*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000097:blood* / Q000000981:diagnostic imaging / Q000188:drug therapy; D011446:Prospective Studies; D012074:Remission Induction / Q000379:methods; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods; D063367:Virtual Reality Exposure Therapy / Q000379:methods
chemical_list: D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D004281:Docosahexaenoic Acids