1
|
Takata K, Imaizumi S, Zhang B, Miura SI, Saku K. Stabilization of high-risk plaques. Cardiovasc Diagn Ther 2016; 6:304-21. [PMID: 27500090 DOI: 10.21037/cdt.2015.10.03] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The prevalence of atherosclerotic cardiovascular diseases (ASCVDs) is increasing globally and they have become the leading cause of death in most countries. Numerous experimental and clinical studies have been conducted to identify major risk factors and effective control strategies for ASCVDs. The development of imaging modalities with the ability to determine the plaque composition enables us to further identify high-risk plaque and evaluate the effectiveness of different treatment strategies. While intensive lipid-lowering by statins can stabilize or even regress plaque by various mechanisms, such as the reduction of lipid accumulation in a necrotic lipid core, the reduction of inflammation, and improvement of endothelial function, there are still considerable residual risks that need to be understood. We reviewed important findings regarding plaque vulnerability and some encouraging emerging approaches for plaque stabilization.
Collapse
Affiliation(s)
- Kohei Takata
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
| | - Satoshi Imaizumi
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
| | - Bo Zhang
- Department of Biochemistry, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
| | - Shin-Ichiro Miura
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
| | - Keijiro Saku
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
| |
Collapse
|
2
|
Iwasaki M, Joki N, Tanaka Y, Hayashi T, Kubo S, Asakawa T, Matsukane A, Takahashi Y, Hirahata K, Imamura Y, Hase H. Declining Prevalence of Coronary Artery Disease in Incident Dialysis Patients Over the Past Two Decades. J Atheroscler Thromb 2014. [DOI: 10.5551/jat.21337] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
3
|
Ishii H, Kobayashi M, Kurebayashi N, Yoshikawa D, Suzuki S, Ichimiya S, Kanashiro M, Sone T, Tsuboi H, Amano T, Uetani T, Harada K, Marui N, Murohara T. Impact of angiotensin II receptor blocker therapy (olmesartan or valsartan) on coronary atherosclerotic plaque volume measured by intravascular ultrasound in patients with stable angina pectoris. Am J Cardiol 2013; 112:363-8. [PMID: 23623047 DOI: 10.1016/j.amjcard.2013.03.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 03/19/2013] [Accepted: 03/19/2013] [Indexed: 10/26/2022]
Abstract
Coronary plaques can be reduced by some medications. The aim of this study was to compare the effects of 2 angiotensin II receptor blockers (olmesartan at 20 mg/day or valsartan at 80 mg/day) on coronary plaque by coronary intravascular ultrasound. One hundred hypertensive patients with stable angina pectoris who underwent elective percutaneous coronary intervention were randomly selected to receive 1 of the 2 angiotensin II receptor blockers after coronary intervention. Nontarget coronary lesions with mild to moderate stenosis were measured by volumetric intravascular ultrasound at baseline and after 6 months. After 6 months, both the olmesartan and the valsartan groups showed significant reduction of the examined coronary plaque volume (46.2 ± 24.1 mm³ at baseline vs 41.6 ± 21.1 mm³ at 6 months: 4.7% decrease, p = 0.0002; and 47.2 ± 32.7 mm³ at baseline vs 42.5 ± 30.2 mm³ at 6 months: 4.8% decrease, p = 0.002, respectively). There was no statistically significant difference of plaque regression between the 2 groups (p = 0.96). In conclusion, there was a significant decrease from baseline in the coronary plaque volume in patients with stable angina pectoris who received olmesartan or valsartan for 6 months. In addition, there was no significant difference in the reduction of plaque volume achieved by these 2 medications.
Collapse
|
4
|
Evaluation of serial changes in tissue characteristics during statin-induced plaque regression using virtual histology-intravascular ultrasound studies. Am J Cardiol 2013; 111:1246-52. [PMID: 23411102 DOI: 10.1016/j.amjcard.2013.01.265] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 01/02/2013] [Accepted: 01/02/2013] [Indexed: 11/21/2022]
Abstract
Treatment of all coronary arteries is important to improve the prognosis of acute coronary syndrome after early reperfusion of the culprit lesion. Early statin treatment has been reported to cause regression of plaques away from the site of the culprit lesion in patients with acute coronary syndrome. However, the precise mechanism of coronary plaque regression is not well understood. We studied the effects of statins on the regression of coronary plaques away from the culprit lesions in 120 patients with acute coronary syndrome. We used virtual histology-intravascular ultrasound studies to evaluate nonpercutaneous coronary intervention lesions at admission and short-term (2 to 3 weeks) and medium-term (8 to 10 months) follow-up. According to the medium-term evaluation findings, the subjects were divided into 2 groups: a plaque regression group (n = 94) and a plaque progression group (n = 26). In the regression group, the fibrofatty component had decreased at the short-term (-20.0% vs baseline) and had decreased further at the medium-term (-26.7%) evaluations. The fibrous component had also decreased at the short-term (-5.1%) and medium-term (-8.5%) evaluations. In contrast, the necrotic core component showed a tendency to increase in the short term (+12.5%) but then decreased at the medium-term evaluation (-6.3%). In the progression group, the fibrofatty and fibrous components had increased at the short-term (+37.5%, +11.3%) and medium-term (+50.5%, +13.2%) evaluations; however, the necrotic core had decreased at the short-term (-19.0%) and medium-term (-23.8%) evaluations. In conclusion, regarding the course of coronary plaque regression by statin therapy, the plaques began to reduce the volume of fibrofatty and fibrous components in the early phase, associated with a transiently increased necrotic core component. Furthermore, even in the case of plaque progression, statins caused a reduction in the necrotic core.
Collapse
|
5
|
D'Ascenzo F, Agostoni P, Abbate A, Castagno D, Lipinski MJ, Vetrovec GW, Frati G, Presutti DG, Quadri G, Moretti C, Gaita F, Zoccai GB. Atherosclerotic coronary plaque regression and the risk of adverse cardiovascular events: A meta-regression of randomized clinical trials. Atherosclerosis 2013. [PMID: 23206978 DOI: 10.1016/j.atherosclerosis.2012.10.065] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
|
6
|
Hirohata A, Yamamoto K, Miyoshi T, Hatanaka K, Hirohata S, Yamawaki H, Komatsubara I, Hirose E, Kobayashi Y, Ohkawa K, Ohara M, Takafuji H, Sano F, Toyama Y, Kusachi S, Ohe T, Ito H. Four-year clinical outcomes of the OLIVUS-Ex (impact of Olmesartan on progression of coronary atherosclerosis: evaluation by intravascular ultrasound) extension trial. Atherosclerosis 2011; 220:134-8. [PMID: 22119063 DOI: 10.1016/j.atherosclerosis.2011.10.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Accepted: 10/04/2011] [Indexed: 01/19/2023]
Abstract
BACKGROUND The previous OLIVUS trial reported a positive role in achieving a lower rate of coronary atheroma progression through the administration of olmesartan, an angiotension-II receptor blocking agent (ARB), for stable angina pectoris (SAP) patients requiring percutaneous coronary intervention (PCI). However, the benefits between ARB administration on long-term clinical outcomes and serial atheroma changes by IVUS remain unclear. Thus, we examined the 4-year clinical outcomes from OLIVUS according to treatment strategy with olmesartan. METHODS Serial volumetric IVUS examinations (baseline and 14 months) were performed in 247 patients with hypertension and SAP. When these patients underwent PCI for culprit lesions, IVUS was performed in their non-culprit vessels. Patients were randomly assigned to receive 20-40mg of olmesartan or control, and treated with a combination of β-blockers, calcium channel blockers, glycemic control agents and/or statins per physician's guidance. Four-year clinical outcomes and annual progression rate of atherosclerosis, assessed by serial IVUS, were compared with major adverse cardio- and cerebrovascular events (MACCE). RESULTS Cumulative event-free survival was significantly higher in the olmesartan group than in the control group (p=0.04; log-rank test). By adjusting for validated prognosticators, olmesartan administration was identified as a good predictor of MACCE (p=0.041). On the other hand, patients with adverse events (n=31) had larger annual atheroma progression than the rest of the population (23.8% vs. 2.1%, p<0.001). CONCLUSIONS Olmesartan therapy appears to confer improved long-term clinical outcomes. Atheroma volume changes, assessed by IVUS, seem to be a reliable surrogate for future major adverse cardio- and cerebrovascular events in this study cohort.
Collapse
|
7
|
Kun X, Yong L, Bo J, Hai-Ming S. Neointimal hyperplasia inhibition effect of angiotensin II type 1 receptor blockers in patients after coronary stent implantation: a meta-analysis. Am J Cardiovasc Drugs 2011; 11:209-13. [PMID: 21619384 DOI: 10.2165/11591780-000000000-00000] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND AND OBJECTIVE It remains unclear whether angiotensin II type 1 receptor antagonists (angiotensin receptor blockers [ARBs]) can inhibit neointimal hyperplasia after stent implantation in patients with coronary artery disease. The aim of this meta-analysis was therefore to evaluate the benefits of ARBs in patients after coronary stent implantation based on the currently available randomized controlled trials. METHODS We conducted a pooled analysis of randomized controlled trials to compare outcomes after stent implantation in patients administered ARBs with those not administered ARBs. We searched Ovid/MEDLINE, EMBASE, and the ISI web of knowledge using the terms 'angiotensin receptor blocker,' 'renin angiotensin system inhibitor,' 'angiotensin receptor antagonist,' 'stent,' 'angiograph,' 'percutaneous coronary intervention (PCI),' and 'coronary artery disease.' Published meta-analyses, review articles, and editorials were reviewed for potential studies of interest. The inclusion criteria were randomized controlled trials published in English, with a follow-up period of 6 months, comparing the outcomes after coronary stent implantation with and without the administration of any kind of ARB, reporting at least one outcome of interest (restenosis rate and late lumen loss). Data abstraction included study design, patient characteristics, follow-up period, type of ARB, type of stent, restenosis rate, and late lumen loss. Fixed-effects models were used to calculate the pooled relative risk for the restenosis rate and the standardized mean difference for late lumen loss. RESULTS Five studies were included, with a total number of 624 patients. Seventy-five of 314 patients in the ARB group were diagnosed with in-stent restenosis at the 6-month follow-up, compared with 87 of 310 patients in the control group (relative risk 0.85; 95% CI 0.65, 1.11; p = 0.23). Consistent with this, there was no significant difference in late lumen loss between the two groups (0.04 mm; 95% CI -0.15, 0.23; p = 0.66). CONCLUSION There is no evident benefit with the use of an ARB in terms of inhibition of neointimal hyperplasia in patients after coronary stent implantation.
Collapse
Affiliation(s)
- Xie Kun
- Department of Cardiology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | | | | | | |
Collapse
|
8
|
Impact of out-stent plaque volume on in-stent intimal hyperplasia: results from serial volumetric analysis with high-gain intravascular ultrasound. Int J Cardiol 2011; 158:235-9. [PMID: 21334084 DOI: 10.1016/j.ijcard.2011.01.058] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2010] [Revised: 01/12/2011] [Accepted: 01/13/2011] [Indexed: 11/22/2022]
Abstract
BACKGROUND Changes in out-stent plaque volume can be related to in-stent intimal hyperplasia. However, few data exist regarding the impact of out-stent plaque volume on in-stent intimal hyperplasia. METHODS We prospectively performed volumetric intravascular ultrasound in 46 stable coronary patients (34 males, mean age of 66 years) immediately as well as 18 months after stenting. From the high-gain ultrasound images, out-stent plaque volume was calculated by extracting the stent volume from the external elastic membrane volume. Volumes of in-stent intimal hyperplasia and reference plaque were also evaluated. RESULTS Out-stent plaque volume increased from 177.3 ± 100.8mm(3) to 190.7 ± 111.1mm(3) (p<0.05) in correlation with increases in-stent intimal hyperplasia (r=0.536, p<0.05). Under these conditions, changes in reference plaque volume correlated with those in LDL-C, which decreased from 121.2 ± 48.0mg/dl to 103.3 ± 48.9 mg/dl (r=0.43, p<0.05). Interestingly, increases in out-stent plaque volume in the silorimus-eluting stent (2.7 ± 1.2%) were lesser than those in the bare-metal stent (14.0 ± 11.0%, p<0.05). CONCLUSIONS These results indicate that irrespective of LDL-C level, changes in out-stent plaque volume correlate with those in in-stent intimal hyperplasia. We suggest that silorimus-eluting stent can suppress in-stent intimal hyperplasia partially by affecting out-stent plaque, although further large-scale studies are required to define the role of out-stent plaque in the occurrence of in-stent intimal hyperplasia.
Collapse
|
9
|
Miura Y, Fukumoto Y, Shiba N, Miura T, Shimada K, Iwama Y, Takagi A, Matsusaka H, Tsutsumi T, Yamada A, Kinugawa S, Asakura M, Okamatsu S, Tsutsui H, Daida H, Matsuzaki M, Tomoike H, Shimokawa H. Prevalence and clinical implication of metabolic syndrome in chronic heart failure. Circ J 2010; 74:2612-21. [PMID: 20953060 DOI: 10.1253/circj.cj-10-0677] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Metabolic syndrome (MetS) is a pathological condition with a clustering of metabolic components and is a well-known risk and prognostic factor for ischemic heart disease (IHD). However, the prevalence and clinical significance of MetS remain to be fully elucidated in chronic heart failure (CHF), an important clinical syndrome caused by various cardiac abnormalities. METHODS AND RESULTS The present nationwide, large-scale clinical study enrolled 3,603 patients with stage C/D CHF from 6 institutes in Japan. First, the prevalence of MetS in CHF patients was demonstrated to be 45% in males and 19% in females, which is more than double compared with the general population in Japan. The CHF patients with MetS were characterized by younger age, higher prevalence of current smoking and drinking, IHD, and hypertensive heart disease, whereas the prevalence of HF with preserved ejection fraction and MetS was higher in elderly female patients. Next, the contribution of the metabolic components (waist circumference, hypertension, glucose intolerance/diabetes mellitus and dyslipidemia) was found to be comparable between the ischemic and the non-ischemic CHF patients. CONCLUSIONS The prevalence of MetS in CHF patients is more than double compared with the general population in Japan and suggest that the metabolic components may have a substantial effect on the development of both ischemic and non-ischemic CHF.
Collapse
Affiliation(s)
- Yutaka Miura
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Luoma PV. Gene activation regresses atherosclerosis, promotes health, and enhances longevity. Lipids Health Dis 2010; 9:67. [PMID: 20604930 PMCID: PMC2909992 DOI: 10.1186/1476-511x-9-67] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Accepted: 07/06/2010] [Indexed: 01/08/2023] Open
Abstract
Background Lifestyle factors and pharmacological compounds activate genetic mechanisms that influence the development of atherosclerotic and other diseases. This article reviews studies on natural and pharmacological gene activation that promotes health and enhances longevity. Results Living habits including healthy diet and regular physical activity, and pharmacotherapy, upregulate genes encoding enzymes and apolipoprotein and ATP-binding cassette transporters, acting in metabolic processes that promote health and increase survival. Cytochrome P450-enzymes, physiological factors in maintaining cholesterol homeostasis, generate oxysterols for the elimination of surplus cholesterol. Hepatic CTP:phosphocholine cytidylyltransferase-α is an important regulator of plasma HDL-C level. Gene-activators produce plasma lipoprotein profile, high HDL-C, HDL2-C and HDL-C/cholesterol ratio, which is typical of low risk of atherosclerotic disease, and also of exceptional longevity together with reduced prevalence of cardiovascular, metabolic and other diseases. High HDL contributes to protection against inflammation, oxidation and thrombosis, and associates with good cognitive function in very old people. Avoiding unhealthy stress and managing it properly promotes health and increases life expectancy. Conclusions Healthy living habits and gene-activating xenobiotics upregulate mechanisms that produce lipoprotein pattern typical of very old people and enhance longevity. Lipoprotein metabolism and large HDL2 associate with the process of living a very long life. Major future goals for health promotion are the improving of commitment to both wise lifestyle choices and drug therapy, and further the developing of new and more effective and well tolerated drugs and treatments.
Collapse
Affiliation(s)
- Pauli V Luoma
- Institute of Biomedicine, Pharmacology, University of Helsinki, Finland.
| |
Collapse
|
11
|
Sinno MCN, Al-Mallah M. Impact of medical therapy on atheroma volume measured by different cardiovascular imaging modalities. Cardiol Res Pract 2010; 2010:134564. [PMID: 20672024 PMCID: PMC2909714 DOI: 10.4061/2010/134564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Accepted: 05/25/2010] [Indexed: 11/20/2022] Open
Abstract
Atherosclerosis is a systemic disease that affects most vascular beds. The gold standard of atherosclerosis imaging has been invasive intravascular ultrasound (IVUS). Newer noninvasive imaging modalities like B-mode ultrasound, cardiac computed tomography (CT), positron emission tomography (PET), and magnetic resonance imaging (MRI) have been used to assess these vascular territories with high accuracy and reproducibility. These imaging modalities have lately been used for the assessment of the atherosclerotic plaque and the response of its volume to several medical therapies used in the treatment of patients with cardiovascular disease. To study the impact of these medications on atheroma volume progression or regression, imaging modalities have been used on a serial basis providing a unique opportunity to monitor the effect these antiatherosclerotic strategies exert on plaque burden. As a result, studies incorporating serial IVUS imaging, quantitative coronary angiography (QCA), B-mode ultrasound, electron beam computed tomography (EBCT), and dynamic contrast-enhanced magnetic resonance imaging have all been used to evaluate the impact of therapeutic strategies that modify cholesterol and blood pressure on the progression/regression of atherosclerotic plaque. In this review, we intend to summarize the impact of different therapies aimed at halting the progression or even result in regression of atherosclerotic cardiovascular disease evaluated by different imaging modalities.
Collapse
Affiliation(s)
- Mohamad C N Sinno
- Heart and Vascular Institute, Henry Ford Hospital, Detroit, MI 48202, USA
| | | |
Collapse
|
12
|
Ako J, Momomura SI. Regression-resistant plaque in diabetic patients. Circ J 2010; 74:1073-4. [PMID: 20472962 DOI: 10.1253/circj.cj-10-0380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
13
|
Hirohata A, Yamamoto K, Miyoshi T, Hatanaka K, Hirohata S, Yamawaki H, Komatsubara I, Murakami M, Hirose E, Sato S, Ohkawa K, Ishizawa M, Yamaji H, Kawamura H, Kusachi S, Murakami T, Hina K, Ohe T. Impact of olmesartan on progression of coronary atherosclerosis a serial volumetric intravascular ultrasound analysis from the OLIVUS (impact of OLmesarten on progression of coronary atherosclerosis: evaluation by intravascular ultrasound) trial. J Am Coll Cardiol 2010; 55:976-82. [PMID: 20202514 DOI: 10.1016/j.jacc.2009.09.062] [Citation(s) in RCA: 87] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2009] [Revised: 08/10/2009] [Accepted: 09/14/2009] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The aim of this study was to evaluate the impact of olmesartan on progression of coronary atherosclerosis. BACKGROUND Prior intravascular ultrasound (IVUS) trial results suggest slowing of coronary atheroma progression with some medicines but have not shown convincing evidence of regression with angiotension-II receptor blocking agents. METHODS A prospective, randomized, multicenter trial-OLIVUS (Impact of OLmesartan on progression of coronary atherosclerosis: evaluation by IntraVascular UltraSound)-was performed in 247 stable angina pectoris patients with native coronary artery disease. When these patients underwent percutaneous coronary intervention for culprit lesions, IVUS was performed in their nonculprit vessels (without angiographically documented coronary stenosis [<50%]). Patients were randomly assigned to receive 10 to 40 mg of olmesartan or control and treated with a combination of beta-blockers, calcium channel blockers, diuretics, nitrates, glycemic control agents, and/or statins per physician's guidance. Serial IVUS examinations (baseline and 14-month follow-up) were performed to assess coronary atheroma volume. Volumetric IVUS analyses included lumen, plaque, vessel volume, percent atheroma volume (PAV), percent change in total atheroma volume (TAV) and PAV. RESULTS Patient characteristics and blood pressure control were identical between the 2 groups. However, follow-up IVUS showed significantly decreased TAV and percent change in PAV in the olmesartan group (5.4% vs. 0.6 % for TAV and 3.1% vs. -0.7% for percent change in PAV, control vs. olmesartan, p < 0.05 for all). CONCLUSIONS These observations suggest a positive role in a potentially lower rate of coronary atheroma progression through the administration of olmesartan, an angiotension-II receptor blocking agent, for patients with stable angina pectoris.
Collapse
|
14
|
Marinsek M, Sinkovic A. A randomized trial comparing the effect of ramipril and losartan in survivors of ST-elevation myocardial infarction. J Int Med Res 2010; 37:1577-87. [PMID: 19930866 DOI: 10.1177/147323000903700536] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study investigated the effect of 8 weeks of treatment with ramipril or losartan on N-terminal pro-brain natriuretic peptide (NT-proBNP) plasma levels, plasminogen activator inhibitor-1 (PAI-1) activity, echocardiographic parameters and lipid profiles in patients after acute myocardial infarction (MI). Patients were randomly assigned to receive up to 10 mg/day ramipril (n = 27) or up to 100 mg/day losartan (n = 26). No significant differences in any of the tested variables were observed between the two treatment groups, either before or after treatment. Within the losartan-treated group a significant decrease in levels of NT-proBNP (211.1 +/- 211.5 versus 94.7 +/- 150.1 pg/ml), total cholesterol (5.7 +/- 1.0 versus 4.6 +/- 1.1 mmol/l), and low-density lipoprotein-cholesterol (3.5 +/- 0.9 versus 2.7 +/- 1.0 mmol/l) was observed after treatment compared with baseline. Thus, after an acute MI, losartan seems equal to ramipril in terms of the NT-proBNP levels, echocardiographic parameters, PAI-1 activity and lipid profiles that were achieved.
Collapse
Affiliation(s)
- M Marinsek
- Department of Medical Intensive Care, University Clinical Centre Maribor, Maribor, Slovenia
| | | |
Collapse
|
15
|
Toi T, Taguchi I, Yoneda S, Kageyama M, Kikuchi A, Tokura M, Kanaya T, Abe S, Matsuda R, Kaneko N. Early Effect of Lipid-Lowering Therapy With Pitavastatin on Regression of Coronary Atherosclerotic Plaque Comparison With Atorvastatin. Circ J 2009; 73:1466-72. [DOI: 10.1253/circj.cj-08-1051] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Toru Toi
- Department of Cardiology and Pneumology, Dokkyo Medical University School of Medicine
| | - Isao Taguchi
- Department of Cardiology and Pneumology, Dokkyo Medical University School of Medicine
| | - Shuichi Yoneda
- Department of Cardiology and Pneumology, Dokkyo Medical University School of Medicine
| | - Michiya Kageyama
- Department of Cardiology and Pneumology, Dokkyo Medical University School of Medicine
| | - Akiko Kikuchi
- Department of Cardiology and Pneumology, Dokkyo Medical University School of Medicine
| | - Michiaki Tokura
- Department of Cardiology and Pneumology, Dokkyo Medical University School of Medicine
| | - Tomoaki Kanaya
- Department of Cardiology and Pneumology, Dokkyo Medical University School of Medicine
| | - Shichiro Abe
- Department of Cardiology and Pneumology, Dokkyo Medical University School of Medicine
| | - Ryuko Matsuda
- Department of Cardiology and Pneumology, Dokkyo Medical University School of Medicine
| | - Noboru Kaneko
- Department of Cardiology and Pneumology, Dokkyo Medical University School of Medicine
| |
Collapse
|
16
|
Bian C, Wu Y, Chen P. Telmisartan Increases the Permeability of Endothelial Cells through Zonula Occludens-1. Biol Pharm Bull 2009; 32:416-20. [DOI: 10.1248/bpb.32.416] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Chang Bian
- Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine
| | - Yihua Wu
- Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine
| | - Peng Chen
- Department of Cardiology, Second Affiliated Hospital, Zhejiang University School of Medicine
| |
Collapse
|
17
|
Takashima H, Ozaki Y, Yasukawa T, Waseda K, Asai K, Wakita Y, Kuroda Y, Kosaka T, Kuhara Y, Ito T. Impact of lipid-lowering therapy with pitavastatin, a new HMG-CoA reductase inhibitor, on regression of coronary atherosclerotic plaque. Circ J 2008; 71:1678-84. [PMID: 17965484 DOI: 10.1253/circj.71.1678] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Recent lipid-lowering trials have reported that statin therapy may retard progression or stimulate regression of human coronary plaque. In the present study volumetric intravascular ultrasound (IVUS) analyses were performed to investigate the effect of pitavastatin, a newly developed statin, on regression of human coronary plaque. METHODS AND RESULTS Eighty-two patients matched for age and gender from 870 consecutive patients undergoing IVUS guided percutaneous coronary intervention were retrospectively assigned to either lipid-lowering therapy (n=41; pitavastatin 2 mg/day) or control group (n=41; diet only). Serial volumetric IVUS analyses of a matched left main coronary arterial site were performed. A significant reduction in low-density lipoprotein-cholesterol (LDL-C) level of 33.2% (p<0.001) was observed in the pitavastatin group. Plaque volume index (PVI) was significantly reduced in the pitavastatin group (10.6+/-9.4% decrease) compared with the control group (8.1+/-14.0% increase, p<0.001). There were positive correlations between the percent change in the PVI and follow-up LDL-C level (r=0.500, p<0.001) and the percent change in LDL-C level (r=0.479, p<0.001). CONCLUSION Lipid-lowering therapy with pitavastatin induced significant coronary plaque regression, associated with a significant reduction in the LDL-C level. The percent change in the PVI showed a significant positive correlation with the percent change in LDL-C level.
Collapse
Affiliation(s)
- Hiroaki Takashima
- Department of Cardiology, Aichi Medical University, School of Medicine, Aichi, Japan.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
18
|
Ozaki Y, Yamaguchi T, Suzuki T, Nakamura M, Kitayama M, Nishikawa H, Inoue T, Hara K, Usuba F, Sakurada M, Awano K, Matsuo H, Ishiwata S, Yasukawa T, Ismail TF, Hishida H, Kato O. Impact of Cutting Balloon Angioplasty (CBA) Prior to Bare Metal Stenting on Restenosis A Prospective Randomized Multicenter Trial Comparing CBA With Balloon Angioplasty (BA) Before Stenting (REDUCE III). Circ J 2007; 71:1-8. [PMID: 17186970 DOI: 10.1253/circj.71.1] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND While stent restenosis and late thrombosis still occur even with drug-eluting-stents (DES), there remains a need to explore other strategies for preventing restenosis. METHODS AND RESULTS Five hundred and twenty-one patients were randomized: 260 to cutting-balloon angioplasty (CBA) before bare-metal stent (CBA-BMS) and 261 to balloon-angioplasty (BA) before BMS (BA-BMS). Intravascular ultrasound (IVUS)-guided procedures were performed in 279 (54%) patients and angiographic guidance was used in the remainder. Minimal lumen diameter was significantly greater in CBA-BMS than BA-BMS (2.65+/-0.40 mm vs 2.52+/-0.4 mm, p<0.01) and % diameter stenosis (%DS)-post was less in CBA-BMS than BA-BMS (14.0+/-5.9% vs 16.3+/-6.8%, p<0.01). %DS-follow-up was subsequently less in CBA-BMS than BA-BMS (32.4+/-15.1% vs 35.4+/-15.3%, p<0.05) associated with lower rates of restenosis in CBA-BMS than BA-BMS (11.8% vs 19.6%, p<0.05) and less target lesion revascularization (TLR) in CBA-BMS than BA-BMS (9.6% vs 15.3%, p<0.05). Patients were divided into 4 groups based on the device used before stenting and IVUS use (IVUS-CBA-BMS: 137 patients; Angio-CBA-BMS: 123; IVUS-BA-BMS: 142; and Angio-BA-BMS: 119). At follow-up IVUS-CBA-BMS had a significantly lower restenosis rate (6.6%) than Angio-CBA-BMS (17.9%), IVUS-BA-BMS (19.8%) and Angio-BA-BMS (18.2%, p<0.05). CONCLUSIONS Restenosis and TLR were significantly lower in CBA-BMS than BA-BMS. This favorable outcome was achieved because of the lower restenosis rate conferred by the IVUS-guided-CBA-BMS strategy (6.6%). The restenosis rates obtained with this strategy were comparable to those achieved with DES.
Collapse
Affiliation(s)
- Yukio Ozaki
- Division of Cardiology, Fujita Health University Hospital, Toyoake, Japan.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|