title: Efficacy of Statin Therapy in Inducing Coronary Plaque Regression in Patients with Low Baseline Cholesterol Levels.
abstract: OBJECTIVE
  The efficacy of statin therapy in inducing coronary plaque regression may depend on baseline cholesterol levels. We aimed to determine the efficacy of statin therapy in inducing coronary plaque regression in statin-naïve patients with low cholesterol levels using serial intravascular ultrasound (IVUS) data from the treatment with statin on atheroma regression evaluated by virtual histology IVUS (TRUTH) study.
  
  
  METHODS
  The TRUTH study is a prospective, multicenter trial, comparing the efficacies of pitavastatin and pravastatin in coronary plaque regression in 164 patients. All patients were statin-naïve and received statin therapy only after study enrollment. The primary endpoint was the observation of coronary plaque progression, despite statin therapy.
  
  
  RESULTS
  Serial IVUS data, at baseline and after an 8-month follow-up, were available for 119 patients. The patients were divided into three groups based on non-high-density lipoprotein cholesterol (HDL-C) levels-low: ≤140 mg/dl, n=38; moderate: 141-169 mg/dl, n=42; and high: ≥170 mg/dl, n=39. Coronary plaque progression was noted in the low cholesterol group, whereas plaque regression was noted in the moderate and high cholesterol groups [%Δplaque volume: 2.3±7.4 vs. －2.7± 10.7 vs. －3.2±7.5, p=0.004 (analysis of variance)]. After adjusting for all variables, a low non-HDL-C level (≤140 mg/dl) was identified as an independent predictor of coronary plaque progression [odds ratio, 3.7; 95% confidence interval, 1.5-9.1, p=0.004].
  
  
  CONCLUSIONS
  Serial IVUS data analysis indicated that statin therapy was less effective in inducing coronary plaque regression in patients with low cholesterol levels but more effective in those with high cholesterol levels at baseline.University Hospital Medical Information Network (UMIN) (UMIN ID: C000000311).
authors.affiliation: Division of Cardiology, Showa University Fujigaoka Hospital.
authors.forename: Kohei
authors.initials: K
authors.lastname: Wakabayashi
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: Shogo
authors.initials: S
authors.lastname: Miyake
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: Hiroshi
authors.initials: H
authors.lastname: Suzuki
authors.forename: Ichiro
authors.initials: I
authors.lastname: Michishita
mesh_terms: D000368:Aged; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy*; D011446:Prospective Studies; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors