Cited by 358Lipoproteins and Cardiovascular HealthCoronary Interventions and DiagnosticsAtherosclerosis and Cardiovascular Diseases

Effect of Intensive Statin Therapy on Regression of Coronary Atherosclerosis in Patients With Acute Coronary Syndrome

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Hiro, Takafumi, Kimura, Takeshi, Morimoto, Takeshi, Miyauchi, Katsumi, Nakagawa, Yoshihisa, Yamagishi, Masakazu, Ozaki, Yukio, Kimura, Kazuo +4 more·2009·Journal of the American College of Cardiology

Abstract

Objectives The objective of this study was to evaluate whether the regressive effects of aggressive lipid-lowering therapy with atorvastatin on coronary plaque volume (PV) in patients with acute coronary syndrome (ACS) are generalized for other statins in multicenter setting.Background A previous single-center study reported beneficial regressive effects of atorvastatin in patients with ACS on PV of the nonculprit site by intravascular ultrasound (IVUS) evaluation. The effect of statins other than atorvastatin on PV has not been evaluated in the setting of ACS.Methods The JAPAN-ACS (Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome) study was a prospective, randomized, open-label, parallel group study with blind end point evaluation conducted at 33 centers in Japan. A total of 307 patients with ACS undergoing IVUS-guided percutaneous coronary intervention were randomized, and 252 patients had evaluable IVUS examinations at baseline and 8 to 12 months' follow-up. Patients were randomly assigned to receive either 4 mg/day of pitavastatin or 20 mg/day of atorvastatin. The primary end point was the percentage change in nonculprit coronary PV.Results The mean percentage change in PV was -16.9 +/- 13.9% and -18.1 +/- 14.2% (p = 0.5) in the pitavastatin and atorvastatin groups, respectively, which was associated with negative vessel remodeling. The upper limit of 95% confidence interval of the mean difference in percentage change in PV between the 2 groups (1.11%, 95% confidence interval: -2.27 to 4.48) did not exceed the pre-defined noninferiority margin of 5%.Conclusions The administration of pitavastatin or atorvastatin in patients with ACS equivalently resulted in significant regression of coronary PV (Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome; NCT00242944).

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Crossref · 10.1016/j.jacc.2009.04.033

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Authors
Hiro, T., Kimura, T., Morimoto, T., Miyauchi, K., Nakagawa, Y., Yamagishi, M., Ozaki, Y., Kimura, K., Saito, S., Yamaguchi, T., Daida, H., & Matsuzaki, M.
Affiliations
  • Yamaguchi University (JP)
  • Kyoto University (JP)
  • Juntendo University (JP)
  • Tenri Hospital (JP)
  • Kanazawa University (JP)
  • Fujita Health University (JP)
  • Yokohama City University Medical Center (JP)
  • Nihon University (JP)
  • Toranomon Hospital (JP)
Corresponding author
Matsuzaki, Masunori
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2009-07
Volume
54
Issue
4
Pages
293-302
ISSN
0735-1097 (ISSN-L)
OpenAlex
W110324665
Cited by
358
References
27
Citations by year
2026: 5 · 2025: 14 · 2024: 13 · 2023: 10 · 2022: 15 · 2021: 22 · 2020: 12 · 2019: 10 · 2018: 19 · 2017: 24 · 2016: 17 · 2015: 20 · 2014: 23 · 2013: 28 · 2012: 42
FWCI
42.58
Type
journal article
Language
en
Open access
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
  • Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
Keywords
acute coronary syndrome, statin therapy, atorvastatin, pitavastatin, coronary plaque volume, plaque regression, intravascular ultrasound, percutaneous coronary intervention, lipid-lowering therapy, vascular remodeling, non-inferiority
MeSH terms
Atorvastatin, Aged, Coronary Artery Disease, Coronary Vessels, Female, Heptanoic Acids, Humans, Male, Middle Aged, Pyrroles, Quinolines, Treatment Outcome, Ultrasonography, Interventional, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Acute Coronary Syndrome

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