Comparison of the effects of pitavastatin versus pravastatin on coronary artery plaque phenotype assessed by tissue characterization using serial virtual histology intravascular ultrasound

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• 作者：Tsuyoshi Nozue (1)
  Shingo Yamamoto (2)
  Shinichi Tohyama (3)
  Kazuki Fukui (4)
  Shigeo Umezawa (5)
  Yuko Onishi (5)
  Tomoyuki Kunishima (6)
  Akira Sato (7)
  Toshihiro Nozato (8)
  Shogo Miyake (9)
  Youichi Takeyama (10)
  Yoshihiro Morino (11)
  Takao Yamauchi (12)
  Toshiya Muramatsu (13)
  Kiyoshi Hibi (14)
  Mitsuyasu Terashima (15)
  Ichiro Michishita (1)
  
  1. Division of Cardiology ; Department of Internal Medicine ; Yokohama Sakae Kyosai Hospital ; Federation of National Public Service Personnel Mutual Associations ; 132 Katsura-cho ; Sakae-ku ; Yokohama ; 247-8581 ; Japan
  2. Department of Cardiology ; Tsurumi Nishiguchi Hospital ; Yokohama ; Japan
  3. Department of Cardiology ; Yokohama Seamen鈥檚 Insurance Hospital ; Yokohama ; Japan
  4. Department of Cardiology ; Kanagawa Cardiovascular and Respiratory Center ; Yokohama ; Japan
  5. Department of Cardiology ; Hiratsuka Kyosai Hospital ; Hiratsuka ; Japan
  6. Fourth Department of Internal Medicine ; Mizonokuchi Hospital ; Teikyo University School of Medicine ; Kawasaki ; Japan
  7. Cardiovascular Center ; Yokosuka Kyosai Hospital ; Yokosuka ; Japan
  8. Department of Cardiology ; National Hospital Organization ; Disaster Medical Center ; Tokyo ; Japan
  9. Department of Cardiology ; Ebina General Hospital ; Ebina ; Japan
  10. Division of Cardiology ; Showa University Fujigaoka Rehabilitation Hospital ; Yokohama ; Japan
  11. Department of Cardiology ; Tokai University School of Medicine ; Isehara ; Japan
  12. Department of Cardiology ; Tokyo Women鈥檚 Medical University ; Tokyo ; Japan
  13. Department of Cardiology ; Saiseikai Yokohama City Eastern Hospital ; Yokohama ; Japan
  14. Division of Cardiology ; Yokohama City University Medical Center ; Yokohama ; Japan
  15. Cardiovascular Imaging Center ; Toyohashi ; Japan
  
• 关键词：Plaque phenotype ; Statin ; Thin ; cap fibroatheroma ; Virtual histology intravascular ultrasound
• 刊名：Heart and Vessels
• 出版年：2015
• 出版时间：January 2015
• 年：2015
• 卷：30
• 期：1
• 页码：36-44
• 全文大小：615 KB
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Cardiology
  Cardiac Surgery
  Vascular Surgery
  Biomedical Engineering
  Interventional Radiology
  Ultrasound
  
• 出版者：Springer Japan
• ISSN：1615-2573

文摘

Thin-cap fibroatheroma (TCFA) is the most common type of vulnerable plaque and is the precursor of plaque rupture. However, rupture of a TCFA is not the only mechanism underlying thrombus formation or acute coronary syndrome. Although statin therapy changes the composition of coronary artery plaques, the effects of statins, particularly different types of statins, on plaque phenotype have not been fully examined. This study compared the effects of pitavastatin versus pravastatin on coronary artery plaque phenotype assessed by virtual histology (VH) intravascular ultrasound (IVUS) in patients with angina pectoris (AP). Coronary atherosclerosis in nonculprit lesions was evaluated using VH-IVUS at baseline and 8 months after statin therapy; analyzable IVUS data were obtained from 83 patients with stable AP (39 patients treated with pitavastatin and 44 with pravastatin) and 36 patients with unstable AP (19 patients treated with pitavastatin and 17 with pravastatin). Pitavastatin had a strong effect on reducing pathologic intimal thickening (PIT), especially in patients with unstable AP, but had no impact on VH-TCFA or fibroatheroma (FA). By contrast, pravastatin had weak effects on reducing PIT, VH-TCFA, or FA. Increases in the number of calcified plaques were observed for both statins. In conclusion, pitavastatin and pravastatin changed coronary artery plaque phenotype as assessed by VH-IVUS in patients with AP. However, the effects of these statins on coronary artery plaque phenotype were different.