Clustering of Metabolic Syndrome Components Attenuates Coronary Plaque Regression During Intensive Statin Therapy in Patients With Acute Coronary Syndrome

Takashima, Hiroaki; Morimoto, Takeshi; Kimura, Takeshi; Hiro, Takafumi; Miyauchi, Katsumi; Nakagawa, Yoshihisa; Yamagishi, Masakazu; Daida, Hiroyuki; Mizuno, Tomofumi; Asai, Kenji; Kuroda, Yasuo; Kubo, Takashi; Kuhara, Yasushi; Kurita, Akiyoshi; Maeda, Keisuke; Amano, Tetsuya; Matsuzaki, Masunori

doi:10.1253/circj.cj-11-1495

Cited by 9 publications

(4 citation statements)

References 32 publications

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“…16 In addition, a stronger decrease in BMI in patients with coronary artery disease (CAD) results in a higher decrease in coronary atherosclerosis, especially in patients with metabolic syndrome. 17 These findings support the hypothesis that patients with obesity have atherosclerotic lesions with higher inflammatory activity that allows stronger inhibitory effect of statins, resulting in a stronger reduction in vessel wall dimension. 18 The presence of diabetes may contribute to even higher inflammatory lesions.…”

Section: Discussionsupporting

confidence: 77%

Guideline treatment results in regression of atherosclerosis in type 2 diabetes mellitus

Strang

Wijk

Mutsaerts

et al. 2015

Diabetes and Vascular Disease Research

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Background: Efficacy of guideline cardiovascular disease prevention regimens may differ between patients with or without type II diabetes mellitus. We therefore compared change in carotid artery wall dimensions in type II diabetes mellitus and non-type II diabetes mellitus patients with a history of a major cardiovascular disease event, using magnetic resonance imaging. Methods: Thirty type II diabetes mellitus patients and 29 age-and sex-matched non-diabetes mellitus patients with a history of stroke or myocardial infarction and a carotid artery stenosis (15%-70%) were included. In all patients, treatment was according to cardiovascular risk management guidelines. At baseline and follow-up, carotid artery vessel wall dimensions were measured using 1.5 T magnetic resonance imaging. Results: After 2 years of follow-up, total wall volume of the carotid artery in type II diabetes mellitus patients decreased by 9.6% (p = 0.016). In contrast, stabilization rather than regression of carotid artery wall dimensions was observed in nondiabetes mellitus patients over a 2-year period. Body mass index was identified as a predictor of total wall volume decrease. Conclusions: Guideline treatment arrests atherogenesis in non-diabetes mellitus patients and even decreases vessel wall dimensions in type II diabetes mellitus patients. Baseline body mass index predicts cardiovascular disease prevention efficacy expressed as decrease in total wall volume. These data emphasize the importance of optimal cardiovascularprevention, particularly in diabetes patients with a high body mass index.

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Section: Discussionsupporting

confidence: 77%

Guideline treatment results in regression of atherosclerosis in type 2 diabetes mellitus

Strang

Wijk

Mutsaerts

et al. 2015

Diabetes and Vascular Disease Research

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“…This has been particularly challenging in patients with diabetes mellitus and the presence of the metabolic syndrome; a population harboring a relatively high overall atherosclerotic cardiovascular disease (ASCVD) risk burden. For the metabolic syndrome, its individual components rather than the metabolic syndrome itself was found to be specifically associated with atherosclerosis progression [ 9 , 23 ]. In a previous analysis, combining data from 5 randomized controlled trials using serial IVUS-imaging, patients with diabetes mellitus had on average greater BMI, and higher prevalence of hypertension, hyperlipidemia, and metabolic syndrome.…”

Section: Discussionmentioning

confidence: 99%

HbA1c, Coronary atheroma progression and cardiovascular outcomes

Dykun

Bayturan

Carlo

et al. 2022

American Journal of Preventive Cardiology

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“…Whilst hypertriglyceridemia and BMI were independent predictors in one study (42), abdominal obesity and high BP were found to be significantly associated in another study where asymptomatic subjects were assessed using CTCA (43). The impact of metabolic syndrome and its components on coronary plaque progression in response to intensive statin therapy was studied in the JAPAN-ACS trial (44). Although percent change in PAV was no different between metabolic syndrome and non-metabolic syndrome group, in the former, response to therapy was attenuated with increasing number of metabolic syndrome components, especially ≥4 risk factors.…”

Section: Metabolic Syndromementioning

confidence: 99%

Imaging of coronary atherosclerosis in various susceptible groups

Munnur

Nerlekar

Wong

2016

Cardiovasc. Diagn. Ther.

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Coronary artery disease (CAD) is the leading cause of death and disability worldwide. Atherosclerosis, which is the primary pathophysiologic mechanism for the development of plaque leading to CAD, is a multifactorial process resulting from a complex interplay between genetic susceptibility and various risk factors such as hypertension (HT), dyslipidaemia, diabetes mellitus (DM) and smoking. In addition, influences from other disease states such as chronic kidney disease (CKD), obesity and the metabolic syndrome as well as gender and ethnic diversity also contribute to the disease process. Insights from pathological observations and advances in cellular and molecular biology have helped us understand the process of plaque formation, progression and rupture leading to events. Several intravascular imaging techniques such as intravascular ultrasound (IVUS), Virtual histology IVUS (VH-IVUS) and optical coherence tomography (OCT) allow in vivo assessment of plaque burden, plaque morphology and response to therapy. In addition, non invasive assessment using coronary artery calcium (CAC) score allows risk stratification and plaque burden assessment whilst computed tomography coronary angiography (CTCA) allows evaluation of luminal stenosis, plaque characterisation and quantification. This review aims to summarise the results of invasive and non-invasive imaging studies of coronary atherosclerosis seen in various high-risk populations including DM, metabolic syndrome, obesity, CKD and, gender differences and ethnicity. Understanding the phenotype of plaques in various susceptible groups may allow potential development of personalised therapies.

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Clustering of Metabolic Syndrome Components Attenuates Coronary Plaque Regression During Intensive Statin Therapy in Patients With Acute Coronary Syndrome

Cited by 9 publications

References 32 publications

Guideline treatment results in regression of atherosclerosis in type 2 diabetes mellitus

Guideline treatment results in regression of atherosclerosis in type 2 diabetes mellitus

HbA1c, Coronary atheroma progression and cardiovascular outcomes

Imaging of coronary atherosclerosis in various susceptible groups

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