Virtual histology evaluation of atherosclerosis regression during atorvastatin and ezetimibe administration: HEAVEN study
Language English Country Japan Media print-electronic
Document type Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't
Grant support
R01 HL063373
NHLBI NIH HHS - United States
PubMed
22076422
DOI
10.1253/circj.cj-11-0730
PII: JST.JSTAGE/circj/CJ-11-0730
Knihovny.cz E-resources
- MeSH
- Anticholesteremic Agents therapeutic use MeSH
- Plaque, Atherosclerotic diagnostic imaging drug therapy pathology MeSH
- Atorvastatin MeSH
- Azetidines therapeutic use MeSH
- Cholesterol metabolism MeSH
- Ezetimibe MeSH
- Ultrasonography, Interventional MeSH
- Single-Blind Method MeSH
- Drug Therapy, Combination MeSH
- Coronary Vessels diagnostic imaging metabolism pathology MeSH
- Heptanoic Acids therapeutic use MeSH
- Middle Aged MeSH
- Humans MeSH
- Lipoproteins metabolism MeSH
- Cell Adhesion Molecules metabolism MeSH
- Coronary Artery Disease diagnostic imaging drug therapy pathology MeSH
- Disease Progression MeSH
- Pyrroles therapeutic use MeSH
- Aged MeSH
- Treatment Outcome MeSH
- Check Tag
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
- Randomized Controlled Trial MeSH
- Research Support, N.I.H., Extramural MeSH
- Names of Substances
- Anticholesteremic Agents MeSH
- Atorvastatin MeSH
- Azetidines MeSH
- Cholesterol MeSH
- Ezetimibe MeSH
- Heptanoic Acids MeSH
- lipoprotein cholesterol MeSH Browser
- Lipoproteins MeSH
- Cell Adhesion Molecules MeSH
- Pyrroles MeSH
BACKGROUND: There is no study focusing on changes in coronary atherosclerosis during dual lipid-lowering therapy with statin and ezetimibe. METHODS AND RESULTS: Eighty-nine patients with stable angina randomized in a 1:1 ratio to Group A (aggressive therapy: atorvastatin 80mg, ezetimibe 10mg) and Group S (standard therapy) were analyzed. Treatment period was 12 months. Coronary arteries were examined by intravascular ultrasound and virtual histology. We found a decrease in the percent atheroma volume (PAV) (-0.4%) in Group A compared with an increase (+1.4%) in Group S (P=0.014) and this was accompanied by an increased frequency of combined atherosclerosis regression (increased lumen volume+decreased PAV) in group A (40.5%) compared with group S (14.9%) (P=0.007). The target low-density lipoprotein cholesterol level <2mmol/L, presence of at least 4 of 5 atherosclerotic risk factors, and decreased level of vascular cellular adhesive molecule were independent predictors of plaque regression. There were no significant differences in plaque composition between the 2 groups over the study duration. However, during analysis of the 2 groups together, fibrous and fibro-fatty tissues decreased and dense calcification and necrotic core increased during follow-up. CONCLUSIONS: Dual lipid-lowering therapy starts atherosclerosis regression, but does not lead to significant changes in plaque composition. The continuous shift in plaque from fibro and fibro-fatty to necrotic with calcification was present in both groups.
References provided by Crossref.org
Effect of ezetimibe on plasma adipokines: a systematic review and meta-analysis
