Effects of Pitavastatin, a 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase Inhibitor, on Cardio-Ankle Vascular Index in Type 2 Diabetic Patients

Miyashita, Yoh; Endo, Kei; Saiki, Atsuhito; Ban, Noriko; Yamaguchi, Takashi; Kawana, Hidetoshi; Nagayama, Daiji; Ohira, Masahiro; Oyama, Tomokazu; Shirai, Kohji

doi:10.5551/jat.281

Cited by 76 publications

(72 citation statements)

References 29 publications

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“…[25][26][27][28] However, although the frequency of use of these medications differed in the two groups in this study, no significant correlation between CAVI and the frequency of use of these medications was observed in the entire study group. Possible explanations for this result are that (1) as the majority of our study subjects were taking at least one of these medications, the interindividual variability of the effect of those medications on CAVI might have been small, (2) this study differed from previous studies [25][26][27][28] in that all our study subjects had significant CAD and several coronary risk factors, which might have resulted in an even smaller favorable effect on arterial stiffness with such medications in this study as compared with previous studies.…”

Section: Discussioncontrasting

confidence: 40%

Head-to-head comparison of the cardio-ankle vascular index between patients with acute coronary syndrome and stable angina pectoris

et al. 2010

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We aimed to evaluate whether there was a difference in the arterial stiffness assessed by the cardio-ankle vascular index (CAVI) between patients with acute coronary syndrome (ACS) and those with stable angina pectoris (SAP). A total of 199 consecutive patients, 79 with ACS and 120 with SAP, who underwent emergency or elective coronary revascularization were enrolled. The CAVI was measured within 2 days after the procedures, and was compared between the ACS and SAP patients. As parameters related to arteriosclerosis, carotid intima-media thickness (IMT) and number of stenotic coronary vessels were also evaluated. Although IMT was significantly greater in SAP patients (2.1 ± 1.1 vs. 2.4 ± 0.9; P¼0.022), CAVI was significantly higher in ACS patients (10.0±1.7 vs. 9.3±1.3; P¼0.0012). After an adjustment for the clinical parameters with a significant difference between the two patient groups, CAVI remained significantly higher in ACS patients than in SAP patients (odds ratio 1.92, 95% confidence interval 1.30-3.02; P¼0.0023). A multiple linear regression analysis revealed that age (b¼0.44; Po0.0001) and ACS (b¼0.3; Po0.0001) were the independent determinants of CAVI. A significant decrease in CAVI was observed at 6 months of follow-up as compared with the acute phase in 18 patients with ACS (10.9±1.6 vs. 10.0±1.5; P¼0.019). In conclusion, CAVI was significantly and independently higher in patients with ACS than in those with SAP, which might result from a transient increase in the CAVI caused by acute myocardial ischemia.

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Section: Discussioncontrasting

confidence: 40%

Head-to-head comparison of the cardio-ankle vascular index between patients with acute coronary syndrome and stable angina pectoris

et al. 2010

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“…It is well known that some medications and factors influence arterial stiffness. [21][22][23][24][25][26][27][28] The possibility that different pharmacological therapies have different effects on this relationship cannot be excluded. Although a patient population of 30 may be relatively small, this study used a longitudinal method.…”

Section: Discussionmentioning

confidence: 99%

Cardio-Ankle Vascular Index Relates to Left Ventricular Ejection Fraction in Patients With Heart Failure

Zhang¹,

Ohira

Iizuka

et al. 2013

Int. Heart J.

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SummaryThe cardio-ankle vascular index (CAVI) has been proposed as a new noninvasive marker of arterial stiffness independent of blood pressure. Arterial stiffness is closely related to afterload, and elevated afterload aggravates heart failure. We hypothesized that CAVI is a potential marker of afterload in patients with heart failure. Thirty patients who were admitted because of acute heart failure were identified retrospectively from a review of clinical records. Plasma brain natriuretic peptide (BNP) levels, CAVI, cardiothoracic ratio (CTR), and echocardiographic parameters obtained during acute and chronic phases of heart failure were analyzed. Left ventricular ejection fraction (LVEF) increased significantly and CTR, BNP and CAVI decreased significantly after treatment of heart failure. A significant negative correlation was observed between the change in CAVI and change in LVEF in all subjects (r = -0.3272, P < 0.05). To examine the relationship between CAVI and LVEF, we divided the patients into two subgroups (∆CAVI < -0.5; CAVI decrease group, ∆CAVI ≥ -0.5; CAVI non-decrease group). CAVI was significantly improved after heart failure treatment only in the CAVI decrease group. LVEF decreased significantly in both groups, but the P value was smaller in the CAVI decrease group than in the CAVI non-decrease group. The change in LVEF correlated significantly with the change in CAVI in the CAVI decrease group (r = -0.4201, P < 0.05), whereas no significant correlation was found in the CAVI non-decrease group. CAVI correlates inversely with LVEF after heart failure treatment. Our results suggest that CAVI might partially reflect the afterload in patients with heart failure. (Int Heart J 2013; 54: 216-221) Key words: Left ventricle ejection fraction, Afterload H eart failure is the inability of the heart to supply adequate blood flow and therefore oxygen to peripheral tissues and organs. It is estimated that there are more than 15 million new cases of heart failure each year worldwide. The overall prevalence of heart failure is increasing because of aging of the population. 1) Heart failure is the leading cause of hospitalization of patients over 65 years of age. Despite many new advances in drug therapy and cardiac assist devices, the prognosis for chronic heart failure remains very poor.Cardiac dysfunction induces changes in vascular function, cardiac output, and neurohumoral status. These changes serve as compensatory mechanisms to help maintain cardiac output (primarily by the Frank-Starling mechanism) and arterial blood pressure (by systemic vasoconstriction). However, these compensatory changes over months and years can worsen cardiac function. This compensation is at the expense of an increase in systemic vascular resistance that increases the afterload on the left ventricle, which can further depress its output. An increase in afterload shifts the Frank-Starling curve downward and to the right. The increased afterload reduces the velocity of fiber shortening. Because the period of time available for ...

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“…In two cases, pitavastatin was suggested to improve not only LDL-C and HDL-C, but also HOMA-IR and GIR. Pitavastatin has pleiotropic effects which do not depend on lipid diminishing actions such as the anti-inflammatory effect [9], antioxidant effect [10] and endothelial function improvement [11]. In addition, it has been confirmed that pitavastatin increases adiponectin in hypercholesterolemic and patients with type 2 diabetes [12], and these actions may contribute to the amelioration of insulin resistance.…”

Section: Discussionmentioning

confidence: 80%

Pitavastatin Ameliorates Insulin Resistance in Type 2 Diabetic Patients: Report of Two Cases

Satoh¹,

Kudoh²,

Hikita³

et al. 2012

J Diabetes Metab

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Introduction: Statins reduce cardiovascular risk in populations targeted for both primary and secondary prevention. The potential of statin use to impact the risk of developing new onset diabetes has been suggested. However, there have been a few large-scale RCTs of pitavastatin which is the statin, but adverse effects on glucose metabolism and diabetes onset were not documented by meta analysis.Case reports: We report two patients with type 2 diabetes and hypercholesterolemia showing amelioration of insulin resistance with pitavastatin. The improvements were attributed to effects of pitavastatin on glucose and insulin metabolism. A 75-year-old man and a 70-year-old woman with type 2 diabetes, hypercholesterolemia and hypertension were given pitavastatin (2 mg/day) for 6 months, without changes in other medication. Before and after treatment, both received euglycemic hyperinsulinemic clamp studies to assess insulin sensitivity. After 6 months, glucose infusion rates were increased in both subjects. Conclusion:These cases suggest that pitavastatin, unlike other statins, has beneficial effects on insulin sensitivity in an insulin-resistant state.

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Effects of Pitavastatin, a 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase Inhibitor, on Cardio-Ankle Vascular Index in Type 2 Diabetic Patients

Cited by 76 publications

References 29 publications

Head-to-head comparison of the cardio-ankle vascular index between patients with acute coronary syndrome and stable angina pectoris

Head-to-head comparison of the cardio-ankle vascular index between patients with acute coronary syndrome and stable angina pectoris

Cardio-Ankle Vascular Index Relates to Left Ventricular Ejection Fraction in Patients With Heart Failure

Pitavastatin Ameliorates Insulin Resistance in Type 2 Diabetic Patients: Report of Two Cases

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