Diabetes Mellitus Is a Major Negative Determinant of Coronary Plaque Regression During Statin Therapy in Patients With Acute Coronary Syndrome - Serial Intravascular Ultrasound Observations From the Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome Trial (the JAPAN-ACS Trial) -
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BACKGROUND: The Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome (JAPAN-ACS) trial has found that early aggressive statin therapy in patients with acute coronary syndrome (ACS) significantly reduces the plaque volume (PV) of non-culprit coronary lesions. The purpose of the present study was to evaluate clinical factors that have an impact on plaque regression using statin therapy. METHODS AND RESULTS: Serial intravascular ultrasound observations over 8-12 months were performed in 252 ACS patients receiving pitavastatin or atorvastatin. Linear regression analysis identified the presence of diabetes mellitus (DM) and PV at baseline as inhibiting factors, and serum remnant-like particle-cholesterol level at baseline as a significant factor significantly affecting the degree of plaque regression. Significant correlation between % change of PV and low-density lipoprotein cholesterol (LDL-C) level was found in patients with DM (n=73, P<0.05, r=0.4), whereas there was no significant correlation between the 2 parameters in patients without DM (n=178). CONCLUSIONS: The regression of coronary plaque induced by statin therapy after ACS was weaker in diabetic patients than their counterparts. Moreover, vigorous reduction of the LDL-C levels might induce a greater degree of plaque regression in ACS patients with DM.
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In the sub-analysis of the TNT study, treatment using a high statin dose significantly suppressed cardiovascular and cerebrovascular events by 25% and 31%, respectively, compared with treatment using the usual statin dose in subjects with coronary artery disease complicated with diabetes.
“In the sub-analysis of the TNT study, which involved subjects with CAD complicated with diabetes, treatment using a high statin dose significantly suppressed cardiovascular and cerebrovascular events by 25% and 31%, respectively, compared to treatment using the usual statin dose753).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [753]
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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., & The JAPAN-ACS Investigators
- Affiliations
- Nihon University (JP)
- Department of Cardiovascular Medicine
- Kyoto University (JP)
- Juntendo University (JP)
- Tenri Hospital (JP)
- Kanazawa University (JP)
- Fujita Health University (JP)
- Yokohama City University Medical Center (JP)
- Division of Cardiovascular Medicine, Keiai Hospital
- Toranomon Hospital (JP)
- Yamaguchi University (JP)
- ORCID
- Venue
- Circulation Journal
- Publisher
- Japanese Circulation Society
- Published
- 2010
- Volume
- 74
- Issue
- 6
- Pages
- 1165-1174
- ISSN
- 1346-9843 (ISSN-L)
- 1347-4820
- OpenAlex
- W2076069465
- Cited by
- 94
- References
- 26
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 3 · 2023: 2 · 2022: 5 · 2020: 6 · 2019: 5 · 2018: 4 · 2017: 5 · 2016: 9 · 2015: 8 · 2014: 8 · 2013: 11 · 2012: 13
- FWCI
- 11.53
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation Journal (publishedVersion)
- PubMed (publishedVersion)
- Institutional Repositories DataBase (IRDB) (submittedVersion)
- Kanazawa University Repository for Academic Resources (DSpace) (Kanazawa University) (submittedVersion, cc-by-nc-nd)
- Funders
- Kowa Company
- Wakayama Medical University
- Fukuoka University
- Fujita Health University
- Japan Heart Foundation
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- diabetes mellitus, coronary plaque regression, acute coronary syndrome, statin therapy, pitavastatin, atorvastatin, plaque volume, remnant-like particle cholesterol, LDL cholesterol
- MeSH terms
- Atorvastatin, Aged, Coronary Artery Disease, Diabetes Mellitus, Female, Heptanoic Acids, Humans, Male, Middle Aged, Pyrroles, Quinolines, Treatment Outcome, Ultrasonography, Interventional, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Acute Coronary Syndrome
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