Format

Send to

Choose Destination
See comment in PubMed Commons below
Circ J. 2017 Oct 25;81(11):1611-1619. doi: 10.1253/circj.CJ-17-0193. Epub 2017 Jun 8.

Effect of Ezetimibe on Stabilization and Regression of Intracoronary Plaque - The ZIPANGU Study.

Author information

1
Cardiovascular Division, Osaka National Hospital.
2
Division of Cardiology, Department of Medicine, Nihon University School of Medicine.
3
Cardiovascular Center, Osaka Gyoumeikan Hospital.
4
Department of Cardiovascular Medicine, Ehime Prefectural Imabari Hospital.
5
Division of Coronary Heart Disease, Hyogo College of Medicine.
6
Department of Cardiology, Hyogo Prefectural Awaji Medical Center.
7
Division of Cardiovascular Medicine, Akabane Central General Hospital.

Abstract

BACKGROUND:

Diminishing yellow color is associated with plaque stabilization. We assessed the hypothesis that a combination of ezetimibe and statin provides more effective plaque stabilization and regression than statin alone as assessed by plaque color.Methods and Results:Stable coronary artery disease patients (n=131) who underwent elective percutaneous coronary intervention and had yellow plaques were randomized to combination therapy (atorvastatin 10-20 mg and ezetimibe 10 mg/day; Group C) or statin monotherapy (atorvastatin 10-20 mg; Group M). Changes in plaque color and plaque volume during 9 months were assessed by angioscopy and intravascular ultrasound. Low-density lipoprotein cholesterol (LDL-C) decreased from 103±28 to 63±18 mg/dL in Group C (P<0.001) and from 100±28 to 75±17 mg/dL in Group M (P<0.001). Yellow color grade decreased significantly in both Group M (2.1±1.1 vs. 1.7±1.0, P=0.005) and Group C (2.2±1.2 vs. 1.8±1.2, P=0.002), but did not differ between the groups. %plaque volume did not change in Group M (48.5±10.2% vs. 48.2±10.4%, P=0.4), but decreased significantly in Group C (50.0±9.8% vs. 49.3±9.8%, P=0.03).

CONCLUSIONS:

Compared with statin monotherapy, combination therapy with ezetimibe further reduced LDL-C levels. Significant plaque volume reduction was achieved by the combination therapy, but not statin monotherapy; however, plaque stabilization was similarly achieved by both therapies. Furthermore, reduction in plaque volume was dependent on reduction in LDL-C, regardless of whether it was achieved by statin alone or statin plus ezetimibe.

KEYWORDS:

Angioscopy; Ezetimibe; Intravascular ultrasound (IVUS); Plaque regression; Plaque stabilization

PMID:
28592751
DOI:
10.1253/circj.CJ-17-0193
Free full text
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for J-STAGE, Japan Science and Technology Information Aggregator, Electronic
    Loading ...
    Support Center