Effects of 4 Statins on Regression of Coronary Plaque in Acute Coronary Syndrome.
BACKGROUND
There is no information on differences in the effects of moderate- and low-intensity statins on coronary plaque in patients with acute coronary syndrome (ACS). The aim of this study was to compare the effects of 4 different statins in patients with ACS, using intravascular ultrasound (IVUS).


RESULTS
A total of 118 patients with ACS who underwent IVUS before percutaneous coronary intervention and who were found to have mild to moderate non-culprit coronary plaques were randomly assigned to receive either 20 mg/day atorvastatin or 4 mg/day pitavastatin (moderate-intensity statin therapy), or 10 mg/day pravastatin or 30 mg/day fluvastatin (low-intensity statin therapy). IVUS at baseline and at end of 10-month treatment was available in 102 patients. Mean percentage change in plaque volume (PV) was -11.1±12.8%, -8.1±16.9%, 0.4±16.0%, and 3.1±20.0% in the atorvastatin, pitavastatin, pravastatin, and fluvastatin groups, respectively (P=0.007, ANOVA). Moderate-intensity statin therapy induced regression of PV, whereas low-intensity statin therapy produced insignificant progression (-9.6% vs. 1.8%, P<0.001). On multivariate linear regression analysis, moderate-intensity statin therapy (P=0.02) and uric acid at baseline (P=0.02) were significant determinants of large percent PV reduction. LDL-C at follow-up did not correlate with percent PV change.


CONCLUSIONS
Moderate-intensity statin therapy induced regression of coronary PV, whereas low-intensity statin therapy resulted in slight progression of coronary PV in patients with ACS. (Circ J 2016; 80: 1634-1643).
Division of Cardiology, Yokohama City University Medical Center.
Kensuke
K
Matsushita
Kiyoshi
K
Hibi
Naohiro
N
Komura
Eiichi
E
Akiyama
Nobuhiko
N
Maejima
Noriaki
N
Iwahashi
Kengo
K
Tsukahara
Masami
M
Kosuge
Toshiaki
T
Ebina
Shinichi
S
Sumita
Satoshi
S
Umemura
Kazuo
K
Kimura
D054058:Acute Coronary Syndrome / Q000473:pathology / Q000628:therapy*; D000368:Aged; D003324:Coronary Artery Disease / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D058226:Plaque, Atherosclerotic / Q000473:pathology / Q000628:therapy*; D011446:Prospective Studies
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors