Author + information
- Received February 4, 2017
- Revision received June 26, 2017
- Accepted July 6, 2017
- Published online June 4, 2018.
- Tsuyoshi Nishiguchi, MD, PhDa,
- Takashi Kubo, MD, PhDa,∗ (, )
- Takashi Tanimoto, MD, PhDb,
- Yasushi Ino, MD, PhDb,
- Yoshiki Matsuo, MD, PhDb,
- Takashi Yamano, MD, PhDb,
- Kosei Terada, MDa,
- Hiroki Emori, MDa,
- Yosuke Katayama, MDa,
- Akira Taruya, MDa,
- Yuichi Ozaki, MD, PhDa,
- Yasutsugu Shiono, MD, PhDb,
- Kunihiro Shimamura, MDb,
- Takeyoshi Kameyama, MD, PhDb,
- Hironori Kitabata, MD, PhDb,
- Tomoyuki Yamaguchi, MD, PhDb,
- Atsushi Tanaka, MD, PhDa,
- Takeshi Hozumi, MD, PhDb and
- Takashi Akasaka, MD, PhDa
- aDepartment of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan
- bDepartment of Cardiovascular Imaging and Dynamics, Wakayama Medical University, Wakayama, Japan
- ↵∗Address for correspondence:
Dr. Takashi Kubo, Department of Cardiovascular Medicine, Wakayama Medical University, 811-1, Kimiidera, Wakayama 641-8510, Japan.
Objectives The aim of the present study was to assess the effect of early statin therapy on fibrous-cap thickness in coronary plaques of patients with acute coronary syndrome (ACS) by using optical coherence tomography.
Background Statins can contribute to the stabilization of coronary plaques.
Methods This is a prospective, randomized, active-controlled, single-center study. Patients with ACS and untreated dyslipidemia were enrolled and randomly allocated (ratio 1:1) to either the early statin group (received pitavastatin 4 mg/day from baseline) or the late statin group (received pitavastatin 4 mg/day from 3 weeks after the baseline). Optical coherence tomography was performed at baseline, 3-week, and 36-week follow-up to assess nonculprit coronary plaques in 53 patients.
Results Between baseline and 3-week follow-up, fibrous-cap thickness increased in the early statin group (140 μm [interquartile range (IQR):120 to 170 μm] to 160 μm [IQR: 130 to 190 μm]; p = 0.017), but decreased in the late statin group (135 μm [IQR: 110 to 183 μm] to 130 μm [IQR: 108 to 160 μm]; p = 0.020). The percentage of increase in fibrous-cap thickness between baseline and 3-week follow-up was significantly greater in the early statin group compared with the late statin group (8.3% [IQR: 0.0% to 21.4%] vs. −5.8% [IQR: −16.0% to 0.0%]; p < 0.001). Between baseline and 36-week follow-up, fibrous-cap thickness increased comparably in the 2 groups.
Conclusions Early therapy with pitavastatin 4 mg/day for patients with ACS provided an increase in fibrous-cap thickness in coronary plaques during the first 3 weeks of follow-up and a further increase during 36 weeks of follow-up. The study was registered with UMIN Clinical Trial Registry (Effect of PitavaStatin on Coronary Fibrous-cap Thickness–Assessment by Fourier-Domain Optical CoheRence Tomography [ESCORT]; UMIN000002678)
Kowa Pharmaceutical Co. Ltd. is the sponsor of the present study. Kowa Pharmaceutical Co. Ltd. had no role in the design, collection, analysis, or interpretation of the data; in the writing of the report; or in the decision to submit the article for publication. Dr. Akasaka has received lecture fees and research funds from Kowa Pharmaceutical Co. Ltd. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received February 4, 2017.
- Revision received June 26, 2017.
- Accepted July 6, 2017.
- 2018 American College of Cardiology Foundation
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