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Cited by 83Fatty Acid Research and HealthLipoproteins and Cardiovascular HealthAtherosclerosis and Cardiovascular Diseases

Effects of the Addition of Eicosapentaenoic Acid to Strong Statin Therapy on Inflammatory Cytokines and Coronary Plaque Components Assessed by Integrated Backscatter Intravascular Ultrasound

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Niki, Toshiyuki, Wakatsuki, Tetsuzo, Yamaguchi, Koji, Taketani, Yoshio, Oeduka, Hiroyasu, Kusunose, Kenya, Ise, Takayuki, Iwase, Takashi +3 more·2016·Circulation Journal
DOI 10.1253/circj.cj-15-0813
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Abstract

BACKGROUND: The effects of eicosapentaenoic acid (EPA) on coronary artery disease have been previously reported; however, those of the addition of EPA to strong statins on coronary plaque components and local inflammatory cytokines are not known. METHODS AND RESULTS: A total of 95 patients who had been treated with strong statin for at least 6 months were randomized into 2 groups: an EPA group (additional treatment with EPA at 1,800 mg/day, n=48) or a control group (no additional treatment, n=47), for 6 months. The tissue characteristics of target coronary plaque in each patient were analyzed using IB-IVUS before and after treatment. We also measured plasma levels of inflammatory cytokines sampled in the coronary sinus (CS) and peripheral vein.A significant reduction in lipid volume (18.5 ± 1.3 to 15.0 ± 1.5 mm(3), P=0.007) and a significant increase in fibrous volume (22.9 ± 0.8 to 25.6 ± 1.1 mm(3), P=0.01) were observed in IB-IVUS image analyses in the EPA group, but no significant changes in the plaque components in the control group. CS levels of pentraxin 3 and monocyte chemoattractant protein-1 were lower after than before treatment with EPA (3.3 ± 2.1 to 2.6 ± 1.2 ng/ml, 120.4 ± 26.2 to 110.2 ± 26.8 pg/ml, P=0.015 and P=0.008, respectively); however, there were no significant changes in those inflammatory cytokines between pre- and post-treatment in the control group. CONCLUSIONS: The addition of EPA was associated with reduced lipid volume in coronary plaques and decreased inflammatory cytokines.

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  • Some clinical studies with higher-dose EPA suggest beneficial effects on markers of oxidation and inflammation, coronary plaque characteristics, and major CV events.

    “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 <scp>REDUCE‐IT</scp> : Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial (2017) · cites this paper as [31]

    The Patient Population section describes a 1,800 mg/day EPA group. The Cytokines and Vulnerable Plaques and Conventional IVUS and IB-IVUS Measurements sections report improved inflammatory markers and coronary plaque components; the Abstract also reports a reduction in major coronary events from JELIS. This paper does not report a beneficial change in markers of oxidation, and its own study did not assess major cardiovascular events. Page numbers are unavailable in our copy. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • 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.

    “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 <scp>REDUCE‐IT</scp> : Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial (2017) · cites this paper as [31]

    Split into 2 atoms — 1 confirmed, 1 partially supported, 0 disputed, 0 misattributed, 0 unverifiable. Expand the claim to see per-atom verdicts.

    Experimental — accuracy not yet measured

  • 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.

    “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 [56]

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Cited by

Sorted by citations

Authors
Niki, T., Wakatsuki, T., Yamaguchi, K., Taketani, Y., Oeduka, H., Kusunose, K., Ise, T., Iwase, T., Yamada, H., Soeki, T., & Sata, M.
Affiliations
Tokushima University Hospital (JP)
ORCID
Venue
Circulation Journal
Publisher
Japanese Circulation Society
Published
2016
Volume
80
Issue
2
Pages
450-460
ISSN
  • 1346-9843 (ISSN-L)
  • 1347-4820
DOI
10.1253/circj.cj-15-0813
OpenAlex
W2330616215
Cited by
83
References
5
Citations by year
2026: 2 · 2025: 5 · 2024: 7 · 2023: 5 · 2022: 9 · 2021: 11 · 2020: 9 · 2019: 10 · 2018: 6 · 2017: 10 · 2016: 8 · 2015: 1
FWCI
8.02
Type
journal article
Language
en
Open access
Locations
  • Circulation Journal (publishedVersion)
  • PubMed (publishedVersion)
  • Institutional Repositories DataBase (IRDB) (submittedVersion)
Funders
  • University of Tokushima
  • Japan Society for the Promotion of Science (25293184)
Topics
  • Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
Keywords
eicosapentaenoic acid, omega-3 fatty acids, statin therapy, coronary artery disease, coronary plaque composition, integrated backscatter intravascular ultrasound, inflammatory cytokines, pentraxin 3, MCP-1
MeSH terms
Aged, Aged, 80 and over, Coronary Artery Disease, Female, Humans, Lipids, Male, Middle Aged, Eicosapentaenoic Acid, Cytokines, Ultrasonography, Interventional, Inflammation Mediators, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Plaque, Atherosclerotic

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