title: Anti-inflammatory and morphologic effects of pitavastatin on carotid arteries and thoracic aorta evaluated by integrated backscatter trans-esophageal ultrasound and PET/CT: a prospective randomized comparative study with pravastatin (EPICENTRE study).
abstract: BACKGROUND
  We sought to evaluate the effects of a strong lipophilic statin (pitavastatin) on plaque components and morphology assessed by transesophageal echocardiography (TEE) and transthoracic echocardiography (TTE), as well as plaque inflammation assessed by 18F-fluorodeoxyglucose (FDG) PET/CT in the thoracic aorta and the carotid artery. Furthermore, we compared the effects of pitavastatin with those of mild hydrophilic statin (pravastatin).
  
  
  METHODS
  We examined atherosclerotic plaques in the thoracic aorta by TEE and those in the carotid artery by integrated backscatter (IBS)-TTE and PET/CT. We identified the target plaque, where there was macrophage infiltration and inflammation, by strong FDG uptake in the thoracic aorta and carotid arteries and measured maximum standard uptake values (max SUV) by PET/CT. We measured the intima-media thickness (IMT) and the corrected IBS (cIBS) values in the intima-media complex by TEE and TTE at the same site of FDG accumulation by PET/CT.
  
  
  RESULTS
  Patients were randomly divided into two treatment groups: a pitavastatin group (PI group: n =10, 68.4 ± 5.1 years) and a pravastatin group (PR group: n =10, 63.9 ± 11.2 years). The same examinations were performed after six months at the same site in each patient. We used calculated target-to-background ratio (TBR) to measure max SUV of plaques and evaluated percent change of TBR. There was no significant difference in low density lipoprotein-cholesterol, TBR, IMT and cIBS values in plaques at baseline between the PI and PR groups. After treatment, there was greater improvement in TBR, cIBS values and IMT in the PI group than the PR group.
  
  
  CONCLUSIONS
  The pravastatin treatment was less effective on plaque inflammation than pitavastatin treatment. This trend was the same in the carotid arteries and the thoracic aorta. Pitavastatin not only improved the atherosis as measured by IMT and cIBS values but also attenuated inflammation of plaques as measured by max SUV at the same site. The present study indicated that pitavastatin has stronger effects on the regression and stabilization of plaques in the thoracic aorta and carotid arteries compared with pravastatin.
authors.affiliation: Department of Cardiology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan. moshimoshi3760@yahoo.co.jp.
authors.forename: Takatomo
authors.initials: T
authors.lastname: Watanabe
authors.affiliation: Department of Cardiology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan. masanori@ya2.so-net.ne.jp.
authors.forename: Masanori
authors.initials: M
authors.lastname: Kawasaki
authors.affiliation: Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan. civ17730@rio.odn.ne.jp.
authors.forename: Ryuhei
authors.initials: R
authors.lastname: Tanaka
authors.affiliation: Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan. onono505koji@live.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Ono
authors.affiliation: Aichi Health Screening Association, Nagoya, Japan. kawasapi2004@yahoo.co.jp.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Kako
authors.affiliation: Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan. maa_075@yahoo.co.jp.
authors.forename: Maki
authors.initials: M
authors.lastname: Saeki
authors.affiliation: Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan. gifu-hp@yahoo.co.jp.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Onishi
authors.affiliation: Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan. cbr02784@nifty.com.
authors.forename: Maki
authors.initials: M
authors.lastname: Nagaya
authors.affiliation: Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan. suzutasato@hop.ocn.ne.jp.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Sato
authors.affiliation: Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan. iceblue778@gmail.com.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Miwa
authors.affiliation: Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan. masazumiarai@yahoo.co.jp.
authors.forename: Masazumi
authors.initials: M
authors.lastname: Arai
authors.affiliation: Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan. tnoda-circ@umin.ac.jp.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Noda
authors.affiliation: Department of Cardiology, Gifu Prefectural General Medical Center, Gifu, Japan. sachirowatanabe@yahoo.co.jp.
authors.forename: Sachiro
authors.initials: S
authors.lastname: Watanabe
authors.affiliation: Department of Cardiology, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194, Japan. minatos@gifu-u.ac.jp.
authors.forename: Shinya
authors.initials: S
authors.lastname: Minatoguchi
mesh_terms: D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D050197:Atherosclerosis / Q000175:diagnosis* / Q000188:drug therapy*; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000187:drug effects*; D017548:Echocardiography, Transesophageal / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D064847:Multimodal Imaging / Q000379:methods; D049268:Positron-Emission Tomography / Q000379:methods; D017035:Pravastatin / Q000008:administration & dosage*; D011804:Quinolines / Q000008:administration & dosage*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018511:Systems Integration; D013895:Thoracic Arteries / Q000000981:diagnostic imaging / Q000187:drug effects*; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000893:Anti-Inflammatory Agents; D011804:Quinolines; D017035:Pravastatin; C108475:pitavastatin