Aged Garlic Extract Reduces Low Attenuation Plaque in Coronary Arteries of Patients with Metabolic Syndrome in a Prospective Randomized Double-Blind Study

Matsumoto, Suguru; Nakanishi, Rine; Liu, Dong; Alani, Anas; Rezaeian, Panteha; Prabhu, Sach; Abraham, Jeby; Fahmy, Michael A; Dailing, Christopher; Flores, Ferdinand; Hamal, Sajad; Broersen, Alexander; Kitslaar, Pieter H.; Budoff, Matthew J.

doi:10.3945/jn.114.202424

Cited by 52 publications

(38 citation statements)

References 30 publications

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“…The initial study sample size was estimated based on MDCTA data showing 24% ± 13% reduction in coronary artery plaque volume with moderate‐dose statin therapy . It is assumed that an 8% reduction in plaque volume (one‐third that seen with statin therapy) would be the minimally important change in noncalcified plaque volume based on past data; multiple studies have shown similar progression/regression rates with different therapies . Further data have been obtained using low‐attenuation plaque volume in both MDCTA and intravascular ultrasound (IVUS) studies.…”

Section: Methodsmentioning

confidence: 99%

Effect of Vascepa (icosapent ethyl) on progression of coronary atherosclerosis in patients with elevated triglycerides (200–499 mg/dL) on statin therapy: Rationale and design of the EVAPORATE study

Budoff

Muhlestein

et al. 2018

Clinical Cardiology

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Despite reducing progression and promoting regression of coronary atherosclerosis, statin therapy does not fully address residual cardiovascular (CV) risk. High‐purity eicosapentaenoic acid (EPA) added to a statin has been shown to reduce CV events and induce regression of coronary atherosclerosis in imaging studies; however, data are from Japanese populations without high triglyceride (TG) levels and baseline EPA serum levels greater than those in North American populations. Icosapent ethyl is a high‐purity prescription EPA ethyl ester approved at 4 g/d as an adjunct to diet to reduce TG levels in adults with TG levels >499 mg/dL. The objective of the randomized, double‐blind, placebo‐controlled EVAPORATE study is to evaluate the effects of icosapent ethyl 4 g/d on atherosclerotic plaque in a North American population of statin‐treated patients with coronary atherosclerosis, TG levels of 200 to 499 mg/dL, and low‐density lipoprotein cholesterol levels of 40 to 115 mg/dL. The primary endpoint is change in low‐attenuation plaque volume measured by multidetector computed tomography angiography. Secondary endpoints include incident plaque rates; quantitative changes in different plaque types and morphology; changes in markers of inflammation, lipids, and lipoproteins; and the relationship between these changes and plaque burden and/or plaque vulnerability. Approximately 80 patients will be followed for 9 to 18 months. The clinical implications of icosapent ethyl 4 g/d treatment added to statin therapy on CV endpoints are being evaluated in the large CV outcomes study REDUCE‐IT. EVAPORATE will provide important imaging‐derived data that may add relevance to the clinically derived outcomes from REDUCE‐IT.

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Section: Methodsmentioning

confidence: 99%

Effect of Vascepa (icosapent ethyl) on progression of coronary atherosclerosis in patients with elevated triglycerides (200–499 mg/dL) on statin therapy: Rationale and design of the EVAPORATE study

Budoff

Muhlestein

et al. 2018

Clinical Cardiology

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“…Thus, prevention of L-type Ca 2+ channels by nifedipine in patients with CAD has led to increased endothelial function and, subsequently, also decreased, though not significantly, the atherosclerotic plaque size in patients with CAD [165]. Moreover, several clinical trials have investigated directly or indirectly the effects of some intervention, related to Ca 2+ , for the treatment of atherosclerosis, as summarized in Table 2 [155,157,158,161,164,165]. For example, in coronary patients undergoing percutaneous intervention, treatment with nifedipine (30-60 mg/day), on top of a statin, for 24 months improved coronary endothelial function [165].…”

Section: Therapeutic Aspectsmentioning

confidence: 99%

Ca2+ Flux: Searching for a Role in Efferocytosis of Apoptotic Cells in Atherosclerosis

Tajbakhsh

Kovanen

Rezaee

et al. 2019

JCM

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In atherosclerosis, macrophages in the arterial wall ingest plasma lipoprotein-derived lipids and become lipid-filled foam cells with a limited lifespan. Thus, efficient removal of apoptotic foam cells by efferocytic macrophages is vital to preventing the dying foam cells from forming a large necrotic lipid core, which, otherwise, would render the atherosclerotic plaque vulnerable to rupture and would cause clinical complications. Ca 2+ plays a role in macrophage migration, survival, and foam cell generation. Importantly, in efferocytic macrophages, Ca 2+ induces actin polymerization, thereby promoting the formation of a phagocytic cup necessary for efferocytosis. Moreover, in the efferocytic macrophages, Ca 2+ enhances the secretion of anti-inflammatory cytokines. Various Ca 2+ antagonists have been seminal for the demonstration of the role of Ca 2+ in the multiple steps of efferocytosis by macrophages. Moreover, in vitro and in vivo experiments and clinical investigations have revealed the capability of Ca 2+ antagonists in attenuating the development of atherosclerotic plaques by interfering with the deposition of lipids in macrophages and by reducing plaque calcification. However, the regulation of cellular Ca 2+ fluxes in the processes of efferocytic clearance of apoptotic foam cells and in the extracellular calcification in atherosclerosis remains unknown. Here, we attempted to unravel the molecular links between Ca 2+ and efferocytosis in atherosclerosis and to evaluate cellular Ca 2+ fluxes as potential treatment targets in atherosclerotic cardiovascular diseases.

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“…The American Journal of Cardiology (www.ajconline.org) Semiautomated quantitative CTA was performed per coronary artery segment 11 using QAngio CT software (Research Edition, version 2.1.2; Medis medical imaging systems, Leiden, the Netherlands) as described in previous studies (Figure 1). 12 We excluded vessels with a diameter <1.5 mm. Seven images with severe motion and noise were excluded.…”

Section: Thismentioning

confidence: 99%

Presence, Characteristics, and Volumes of Coronary Plaque Determined by Computed Tomography Angiography in Young Type 2 Diabetes Mellitus

Nezarat

Budoff

Luo

et al. 2017

The American Journal of Cardiology

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Aged Garlic Extract Reduces Low Attenuation Plaque in Coronary Arteries of Patients with Metabolic Syndrome in a Prospective Randomized Double-Blind Study

Cited by 52 publications

References 30 publications

Effect of Vascepa (icosapent ethyl) on progression of coronary atherosclerosis in patients with elevated triglycerides (200–499 mg/dL) on statin therapy: Rationale and design of the EVAPORATE study

Effect of Vascepa (icosapent ethyl) on progression of coronary atherosclerosis in patients with elevated triglycerides (200–499 mg/dL) on statin therapy: Rationale and design of the EVAPORATE study

Ca2+ Flux: Searching for a Role in Efferocytosis of Apoptotic Cells in Atherosclerosis

Presence, Characteristics, and Volumes of Coronary Plaque Determined by Computed Tomography Angiography in Young Type 2 Diabetes Mellitus

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