Effects of 4 Statins on Regression of Coronary Plaque in Acute Coronary Syndrome

Matsushita, Kensuke; Hibi, Kiyoshi; Komura, Naohiro; Akiyama, Eiichi; Maejima, Nobuhiko; Iwahashi, Noriaki; Tsukahara, Kengo; Kosuge, Masami; Ebina, Toshiaki; Sumita, Shinichi; Umemura, Satoshi; Kimura, Kazuo

doi:10.1253/circj.cj-15-1379

Cited by 23 publications

(24 citation statements)

References 43 publications

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“…A total of 17 studies with 34 study arms published between 2001 and 2018 were included (Table 1). Three studies were non-randomized trials [9,11,13] and four studies only included patients with ACS [8,12,20,22]. Among the 17 studies, three were placebo-controlled, and the rest were all lipid therapy studies with a wide range of types and doses administered ( Table 1).…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Coronary atheroma regression and adverse cardiac events: A systematic review and meta-regression analysis

Bhindi

Guan²,

Zhao³

et al. 2019

Atherosclerosis

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Meta-regression analysis of trials using intravascular ultrasound to assess regression induced by lipid medications was performed. • A 1% decrease in percent atheroma volume was associated with approximately a 20% reduction in the odds of incurring a major cardiovascular event.• Percent atheroma volume changes represent a surrogate measure of cardiovascular events. A R T I C L E I N F O Keywords:Atherosclerosis Plaque regression Major adverse cardiac events Intravascular ultrasound Anti-atherosclerotic therapy A B S T R A C TBackground and aims: The relationship between plaque regression induced by dyslipidemia therapies and occurrence of major adverse cardiovascular events (MACE) is controversial. We performed a systematic review and meta-regression of dyslipidemia therapy studies reporting MACE and intravascular ultrasound (IVUS) measures of change in coronary atheroma. Methods: Prospective studies of dyslipidemia therapies reporting percent atheroma volume (PAV) measured by IVUS and reporting death, myocardial infarction, stroke, unstable angina or transient ischemic attack (MACE) were included. The association between mean change in PAV and MACE was examined using meta-regression via mixed-effects binomial logistic regression models, unadjusted and adjusted for mean age, baseline PAV, baseline low density lipoprotein-cholesterol and study duration. Results: The study included 17 prospective studies published between 2001 and 2018 totaling 6333 patients. Study duration varied from 11 to 104 weeks. Mean change in PAV, across the study arms, ranged from −5.6% to 3.1%. MACE ranged from 0 to 72 events per study arm: 13 study arms (38%) reported no events, 8 (24%) reported 1-2 events and 13 (38%) reported 3 or more events. Meta-regression demonstrated a decline in the odds of MACE associated with reduction in mean PAV: unadjusted odds ratio (OR): 0.78, 95% Confidence Interval (CI): [0.63, 0.96], p = 0.018; adjusted OR: 0.82, 95% CI: [0.70, 0.95], p = 0.011, per 1% decrease in mean PAV. Conclusions: A 1% reduction in mean PAV as induced by dyslipidemia therapies was associated with a 20% reduction in the odds of MACE.

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Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Coronary atheroma regression and adverse cardiac events: A systematic review and meta-regression analysis

Bhindi

Guan²,

Zhao³

et al. 2019

Atherosclerosis

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show abstract

“…18 By reducing the plasma LDL-C, statins reduce the risk of death and cardiovascular events across the range of LDL-C. 1 Recent RCT reported that a higher intensity statin dosing regimen was more beneficial than standard intensity statin in ACS or stable angina. 2-6, 19 A recent meta-analysis also noted higher benefit of high-intensity statin in reducing the risks of coronary death, MI, revascularization and stroke. 6 In this regard, current ACCF/AHA and ESC guidelines state the initiation of high-intensity statin after AMI as a class I recommendation.…”

Section: Current Evidence For Statin Use After Amimentioning

confidence: 99%

Effects of Statin Intensity on Clinical Outcome in Acute Myocardial Infarction Patients

Hwang

Kim

Lee

et al. 2018

Circ J

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“…There were 2 deaths (cardiac death in 1 and non-cardiac in Theoretically, specific strategies targeting LDL-C in ACS may be beneficial with regard to the regression of atherosclerosis. 21 Ezetimibe has been shown to reduce the levels of inflammatory markers, 12,22 improve endothelial function, 23 and lower LCL-C by approximately 15% beyond non-culprit atherosclerotic plaque or change in plaque tissue characteristics in statin-naïve patients with ACS; and (4) the results were consistent across subgroups stratified according to the markers of cholesterol synthesis and absorption. Advance Publication by-J-STAGE disease (ASCVD).…”

Section: Discussionmentioning

confidence: 97%

Effects of Ezetimibe-Statin Combination Therapy on Coronary Atherosclerosis in Acute Coronary Syndrome

Hibi

Sonoda

Kawasaki

et al. 2018

Circ J

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Effects of 4 Statins on Regression of Coronary Plaque in Acute Coronary Syndrome

Cited by 23 publications

References 43 publications

Coronary atheroma regression and adverse cardiac events: A systematic review and meta-regression analysis

Coronary atheroma regression and adverse cardiac events: A systematic review and meta-regression analysis

Effects of Statin Intensity on Clinical Outcome in Acute Myocardial Infarction Patients

Effects of Ezetimibe-Statin Combination Therapy on Coronary Atherosclerosis in Acute Coronary Syndrome

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