- 作者：Ryo Nishio ; Toshiro Shinke ; shinke820@aol.com" class="auth_mail ; shinke@med.kobe-u.ac.jp" class="auth_mail ; Hiromasa Otake ; Masayuki Nakagawa ; Ryoji Nagoshi ; Takumi Inoue ; Amane Kozuki ; Hirotoshi Hariki ; Tsuyoshi Osue ; Yu Taniguchi ; Masamichi Iwasaki ; Noritoshi Hiranuma ; Akihide Konishi ; Hiroto Kinutani ; Junya Shite ; Ken-ichi Hirata
- 关键词：Eicosapentaenoic acid ; Thin-cap fibroatheroma ; Optical coherence tomography ; Pentraxin-3
- 刊名：Atherosclerosis
- 出版年：May, 2014
- 年：2014
- 卷：234
- 期：1
- 页码：114-119
- 全文大小：788 K
Background
The addition of highly purified eicosapentaenoic acid (EPA) to statin therapy prevents cardiovascular events. However, the impact of this treatment on vulnerable plaques remains unclear. The aim of this study was to assess the impact of adding EPA to a standard statin therapy on vulnerable plaques by serial optical coherence tomography (OCT).Methods
Forty-nine non-culprit thin-cap fibroatheroma (TCFA) lesions in 30 patients with untreated dyslipidemia were included. Patients were randomly assigned to EPA (1800聽mg/day)聽+聽statin (23 TCFA, 15 patients) or statin only (26 TCFA, 15 patients) treatment. The statin (rosuvastatin) dose was adjusted to achieve a target low-density lipoprotein (LDL) level of <70聽mg/dL. Post-percutaneous intervention and 9-month follow-up OCT were performed to evaluate morphological changes of TCFAs. The EPA/arachidonic acid (EPA/AA) ratio and pentraxin-3 (PTX3) levels were also evaluated.
Results
Despite similar follow-up LDL levels, the EPA聽+聽statin group had higher EPA/AA ratios and lower PTX3 levels than the statin group. OCT analysis showed that the EPA聽+聽statin group had a greater increase in fibrous-cap thickness, with a greater decrease in lipid arc and lipid length. Macrophage accumulation was less frequently detected in the EPA聽+聽statin group than in the statin group at follow-up. When the patients were categorized according to their follow-up PTX3 tertiles, fibrous-cap thickness showed significant increase, and the incidence of macrophages accumulation decreased with lower PTX3 levels.
Conclusion
The concomitant use of EPA and rosuvastatin may stabilize vulnerable plaques better than the statin alone, possibly by suppressing arterial inflammation.