- 著者
-
Koichiro Fujisue
Kenshi Yamanaga
Suguru Nagamatsu
Hideki Shimomura
Takuro Yamashita
Koichi Nakao
Sunao Nakamura
Masaharu Ishihara
Kunihiko Matsui
Naritsugu Sakaino
Takashi Miyazaki
Nobuyasu Yamamoto
Shunichi Koide
Toshiyuki Matsumura
Kazuteru Fujimoto
Ryusuke Tsunoda
Yasuhiro Morikami
Koushi Matsuyama
Shuichi Oshima
Kenji Sakamoto
Yasuhiro Izumiya
Koichi Kaikita
Seiji Hokimoto
Hisao Ogawa
Kenichi Tsujita
- 出版者
- Japan Atherosclerosis Society
- 雑誌
- Journal of Atherosclerosis and Thrombosis (ISSN:13403478)
- 巻号頁・発行日
- pp.54726, (Released:2020-05-20)
- 参考文献数
- 29
- 被引用文献数
-
6
Aim: Coronary plaque regression is weak in acute coronary syndrome (ACS) patients with diabetes mellitus (DM). We evaluated whether dual lipid-lowering therapy (DLLT) with ezetimibe and atorvastatin attenuates coronary plaques in ACS patients with DM. Methods: The prospective, randomized controlled, multicenter PRECISE-IVUS (Plaque Regression with Cholesterol Absorption Inhibitor or Synthesis Inhibitor Evaluated by Intravascular Ultrasound) trial assigned 246 patients undergoing percutaneous coronary intervention to DLLT or atorvastatin monotherapy and evaluated IVUS-derived changes in percent atheroma volume (ΔPAV), at baseline and 9-12-month follow-up, in 126 ACS cases, including 25 DM patients. The atorvastatin dose was up-titrated to achieve low-density lipoprotein cholesterol (LDL-C) <70 mg/dL. Results: In DM patients, the monotherapy group (n=13) and the DLLT group (n=12) showed a similar prevalence of coronary risks and baseline lipid profiles. During the study, the change in LDL-C level was similar between DM and non-DM patients. Compared with non-DM patients, DM patients showed weaker regression of ΔPAV by DLLT than those who underwent monotherapy (DM: −2.77±3.47% vs. −0.77±2.51%, P=0.11; non-DM: −2.01±3.36% vs. −0.08±2.66%, P=0.008). The change in LDL-C level was not correlated with ΔPAV in non-DM patients, but there was significant correlation between the change in LDL-C level and ΔPAV in DM patients (r=0.52, P=0.008). Conclusions: ACS patients with DM showed weaker coronary plaque regression than their counterparts. A significant correlation between the change in LDL-C level and ΔPAV in DM patients suggested that more intensive lipid-lowering therapy is required in ACS patients with DM.