The DOI matches its Crossref record; 29 of the 29 references it cites were found in a registry or an index.
Stabilizing effect of combined eicosapentaenoic acid and statin therapy on coronary thin-cap fibroatheroma
Abstract
Background The addition of highly purified eicosapentaenoic acid (EPA) to statin therapy prevents cardiovascular events. However, the impact of this treatment on vulnerable plaques remains unclear. The aim of this study was to assess the impact of adding EPA to a standard statin therapy on vulnerable plaques by serial optical coherence tomography (OCT).Methods Forty-nine non-culprit thin-cap fibroatheroma (TCFA) lesions in 30 patients with untreated dyslipidemia were included. Patients were randomly assigned to EPA (1800 mg/day) + statin (23 TCFA, 15 patients) or statin only (26 TCFA, 15 patients) treatment. The statin (rosuvastatin) dose was adjusted to achieve a target low-density lipoprotein (LDL) level of <70 mg/dL. Post-percutaneous intervention and 9-month follow-up OCT were performed to evaluate morphological changes of TCFAs. The EPA/arachidonic acid (EPA/AA) ratio and pentraxin-3 (PTX3) levels were also evaluated.Results Despite similar follow-up LDL levels, the EPA + statin group had higher EPA/AA ratios and lower PTX3 levels than the statin group. OCT analysis showed that the EPA + statin group had a greater increase in fibrous-cap thickness, with a greater decrease in lipid arc and lipid length. Macrophage accumulation was less frequently detected in the EPA + statin group than in the statin group at follow-up. When the patients were categorized according to their follow-up PTX3 tertiles, fibrous-cap thickness showed significant increase, and the incidence of macrophages accumulation decreased with lower PTX3 levels.Conclusion The concomitant use of EPA and rosuvastatin may stabilize vulnerable plaques better than the statin alone, possibly by suppressing arterial inflammation.
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“In addition to beneficial changes to TG‐rich lipoproteins and other plasma lipid markers, some clinical studies with higher‐dose EPA also suggest beneficial effects on markers of oxidation and inflammation, coronary plaque characteristics, and major CV events.16, 25, 26, 29, 31, 32, 33”
From Rationale and design of REDUCE‐IT : Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial (2017) · cites this paper as [32]
In the citing paper
“Finally, studies administering higher‐dose EPA suggest additional beneficial effects beyond lipid‐lowering that may be unique to EPA relative to other TG‐lowering therapies, such as beneficial changes in coronary plaque characteristics, which may lead to reductions in major CV events.4, 16, 25, 26, 27, 28, 29, 30, 31, 32, 33”
From Rationale and design of REDUCE‐IT : Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial (2017) · cites this paper as [32]
In the citing paper
“EPA has unique lipid and lipoprotein, antiinflammatory, antiplatelet, antithrombotic, and cellular modifying effects, all of which may contribute to benefits in atherosclerotic processes such as reduced development, slowed progression, and increased stabilization of atherosclerotic plaque (19,(54)(55)(56).”
From Effects of Icosapent Ethyl on Total Ischemic Events (2019) · cites this paper as [55]
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“Further, several studies have reported that the low baseline value for the EPA/arachidonic acid (AA) ratio is related to worse clinical outcomes and plaque vulnerability in coronary artery disease patients.(6-11) We have published the HIJ-PROPER (Heart Institute of Japan Proper”
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Metadata
- Authors
- Nishio, R., Shinke, T., Otake, H., Nakagawa, M., Nagoshi, R., Inoue, T., Kozuki, A., Hariki, H., Osue, T., Taniguchi, Y., Iwasaki, M., Hiranuma, N., Konishi, A., Kinutani, H., Shite, J., & Hirata, K.-I.
- Affiliations
- Kobe University (JP)
- ORCID
- Venue
- Atherosclerosis
- Publisher
- Elsevier BV
- Published
- 2014-05
- Volume
- 234
- Issue
- 1
- Pages
- 114-119
- ISSN
- 0021-9150 (ISSN-L)
- OpenAlex
- W2048776656
- Cited by
- 133
- References
- 29
- Citations by year
- 2026: 2 · 2025: 10 · 2024: 9 · 2023: 16 · 2022: 20 · 2021: 14 · 2020: 14 · 2019: 13 · 2018: 3 · 2017: 9 · 2016: 11 · 2015: 10 · 2014: 2
- FWCI
- 9.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Atherosclerosis (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Keywords
- eicosapentaenoic acid, statin therapy, rosuvastatin, thin-cap fibroatheroma, coronary artery disease, pentraxin 3, fibrous cap thickness, lipid arc, macrophage accumulation, arterial inflammation, dyslipidemia, percutaneous coronary intervention
- MeSH terms
- Coronary Artery Disease, Drug Therapy, Combination, Female, Humans, Male, Middle Aged, Eicosapentaenoic Acid, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Tomography, Optical Coherence, Plaque, Atherosclerotic
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