Coronary Plaque Regression and Lifestyle Modification in Patients Treated With Pravastatin  - Assessment Mainly by Daily Aerobic Exercise and an Increase in the Serum Level of High-Density Lipoprotein Cholesterol -

Tani, Shigemasa; Nagao, Ken; Anazawa, Takeo; Kawamata, Hirofumi; Furuya, Shinichi; Takahashi, Hiroshi; Iida, Kiyoshi; Matsumoto, Michiaki; Washio, Takehiko; Kumabe, Narimichi; Hirayama, Atsushi

doi:10.1253/circj.cj-09-0705

Cited by 35 publications

(15 citation statements)

References 37 publications

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“…This latter observation may explain certain effects of treatments on atherosclerotic plaques, in particular, the observation that plaque regression can occur when the treatments augments the HDL-C levels [2]. Our previous studies and other studies have also shown that an increase in the serum HDL-C level is an independent predictor of coronary plaque regression [6,10].…”

Section: Discussionmentioning

confidence: 58%

“…We have previously reported that a decreased peripheral monocyte count and elevated serum HDL-C level are independently involved in the effect of statins in promoting regression of coronary plaques [5,6]. As described before, monocytes and HDL-C have apparently opposing functions in the progression or inhibition of atherosclerosis.…”

Section: Introductionmentioning

confidence: 74%

“…Subsequently, the patients' LDL-C levels were monitored and the dose of pravastatin was adjusted to maintain the LDL-C level at below 100 mg/dl throughout the course of the study. All the patients also received dietary and lifestyle-modification counseling [6].…”

Section: Study Design and Populationmentioning

confidence: 99%

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Development of a model for prediction of coronary atherosclerotic regression: evaluation of high-density lipoprotein cholesterol level and peripheral blood monocyte count

et al. 2011

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Monocytes and high-density lipoprotein cholesterol (HDL-C) play important roles in the process of coronary atherosclerosis. We hypothesized that a reasonable predictive model of coronary plaque regression might be constructed using the change in the peripheral monocyte count and the serum HDL-C level. The plaque volume, as assessed by volumetric intravascular ultrasound, was measured at the baseline and after 6 months of pravastatin therapy in 114 patients with coronary artery disease. After 6 months of pravastatin therapy, a significant decrease of the plaque volume by 9.9% (p < 0.0001, vs. baseline) was observed; furthermore, a corresponding increase of the serum HDL-C level and decrease of the peripheral blood monocyte count were also seen (12.5%, p < 0.01 and -7.3%, p < 0.0001). In a multivariate regression analysis using the serum lipids and traditional risk factors as the covariates, the increase in the serum HDL-C (β -0.56, p < 0.0001) and the decrease in monocyte count (β 0.23, p = 0.03) were identified as independent predictors of the plaque regression. A model for the prediction of plaque regression according to whether the achieved the change in (Δ) monocyte count and ΔHDL-C were above or below the median values was prepared. Among the four groups, the group with ΔHDL-C ≥8.8% and Δmonocyte count ≤-8.6% showed the largest plaque regression (-20.4%), and the group with ΔHDL-C <8.8% and Δmonocyte count >-8.6% showed the increase of the plaque volume (2.6%). In view of the inflammatory nature of atherosclerosis, the model constructed using the two predictors may be a useful model for the prediction of plaque regression.

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Section: Discussionmentioning

confidence: 58%

Section: Introductionmentioning

confidence: 74%

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Development of a model for prediction of coronary atherosclerotic regression: evaluation of high-density lipoprotein cholesterol level and peripheral blood monocyte count

et al. 2011

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“…Lifestyle modification was assessed by a questionnaire with special focus on daily exercise, weight management, and smoking status. Multivariate regression analysis revealed that lifestyle modification independently predicted plaque regression, leading the authors to conclude that increased physical activity may play an important role 98. However, the change in physical activity over time was not reported and not correlated with plaque regression, independent of other lifestyle factors.…”

Section: Mechanism 3: Regression Of Coronary Stenosismentioning

confidence: 98%

Physical Activity in the Prevention and Treatment of Coronary Artery Disease

Winzer

Woitek

Linke

2018

JAHA

171

120

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“…However, Tani et al reported that successful life style modification with exercise, body weight reduction and smoking cessation for 6 months was associated with coronary plaque volume regression in low prognostic risk CAD patients. 34 Belardinelli et al reported in the ETICA (Exercise Training Intervention after Coronary Angioplasty) trial that a 6-month OPCR for the relatively low risk CAD patients after successful PCI (49% having AMI) reduced cardiac events and hospital re-admission during the follow-up period (33±7 months). 35 In addition, because the magnitude of the improvement in endothelial function afforded by OPCR does not correlate with the improvements in CRF, 36 the general consensus at present is that the favorable effect of OPCR on the long-term prognosis is mediated by a direct anti-atherosclerosis effect of exercise training rather than by improvements in CRF.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Out-Patient Cardiac Rehabilitation in Low Prognostic Risk Patients After Acute Myocardial Infarction in Primary Intervention Era

Kamakura

Kawakami

Nakanishi

et al. 2011

Circ J

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Background:The efficacy of out-patient cardiac rehabilitation (OPCR) in patients with a low prognostic risk after acute myocardial infarction (AMI) is unclear in the recent primary intervention era. Methods and Results:A total of 637 AMI patients who participated in in-hospital cardiac rehabilitation were divided into 2 groups; low prognostic risk group (n=219; age <65 years, successful reperfusion, Killip class I, peak serum creatine kinase <6,000 U/L, and left ventricular ejection fraction ≥40%) and non-low prognostic risk group (n=418). The prevalence of coronary risk factors (CRF) was compared between the 2 groups. Then, in the lowrisk group, the efficacy of OPCR was compared between active OPCR participants (n=52; ≥20 sessions/3 months) and non-active participants (n=60; <6 sessions/3 months). Compared with the non-low prognostic risk group, the low prognostic risk group had a significantly higher prevalence of current smokers (72% vs. 49%, P<0.05) and patients with multiple CRF (3 or more; 49% vs. 39%, P<0.05). Among the low- risk group, active OPCR participants showed a significantly greater improvement in exercise capacity (peak V• O2, P<0.05) and maintained a better CRF profile (total cholesterol, triglyceride and blood pressure, all P<0.05) than inactive participants at 3 months.Conclusions: Low prognostic risk AMI patients have a higher prevalence of multiple CRF than non-low risk patients. Even in this low risk group, active participation in OPCR is associated with improved exercise capacity and better CRF profile. (Circ J 2011; 75: 315 - 321)

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Coronary Plaque Regression and Lifestyle Modification in Patients Treated With Pravastatin - Assessment Mainly by Daily Aerobic Exercise and an Increase in the Serum Level of High-Density Lipoprotein Cholesterol -

Cited by 35 publications

References 37 publications

Development of a model for prediction of coronary atherosclerotic regression: evaluation of high-density lipoprotein cholesterol level and peripheral blood monocyte count

Development of a model for prediction of coronary atherosclerotic regression: evaluation of high-density lipoprotein cholesterol level and peripheral blood monocyte count

Physical Activity in the Prevention and Treatment of Coronary Artery Disease

Efficacy of Out-Patient Cardiac Rehabilitation in Low Prognostic Risk Patients After Acute Myocardial Infarction in Primary Intervention Era

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