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Effect of Early Pitavastatin Therapy on Coronary Fibrous-Cap Thickness Assessed by Optical Coherence Tomography in Patients With Acute Coronary Syndrome: The ESCORT Study.
JACC: Cardiovascular Imaging ( IF 12.8 ) Pub Date : 2017-09-13 , DOI: 10.1016/j.jcmg.2017.07.011 Tsuyoshi Nishiguchi 1 , Takashi Kubo 1 , Takashi Tanimoto 2 , Yasushi Ino 2 , Yoshiki Matsuo 2 , Takashi Yamano 2 , Kosei Terada 1 , Hiroki Emori 1 , Yosuke Katayama 1 , Akira Taruya 1 , Yuichi Ozaki 1 , Yasutsugu Shiono 2 , Kunihiro Shimamura 2 , Takeyoshi Kameyama 2 , Hironori Kitabata 2 , Tomoyuki Yamaguchi 2 , Atsushi Tanaka 1 , Takeshi Hozumi 2 , Takashi Akasaka 1
JACC: Cardiovascular Imaging ( IF 12.8 ) Pub Date : 2017-09-13 , DOI: 10.1016/j.jcmg.2017.07.011 Tsuyoshi Nishiguchi 1 , Takashi Kubo 1 , Takashi Tanimoto 2 , Yasushi Ino 2 , Yoshiki Matsuo 2 , Takashi Yamano 2 , Kosei Terada 1 , Hiroki Emori 1 , Yosuke Katayama 1 , Akira Taruya 1 , Yuichi Ozaki 1 , Yasutsugu Shiono 2 , Kunihiro Shimamura 2 , Takeyoshi Kameyama 2 , Hironori Kitabata 2 , Tomoyuki Yamaguchi 2 , Atsushi Tanaka 1 , Takeshi Hozumi 2 , Takashi Akasaka 1
Affiliation
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OBJECTIVES
The aim of the present study was to assess the effect of early statin therapy on fibrous-cap thickness in coronary plaques of patients with acute coronary syndrome (ACS) by using optical coherence tomography.
BACKGROUND
Statins can contribute to the stabilization of coronary plaques.
METHODS
This is a prospective, randomized, active-controlled, single-center study. Patients with ACS and untreated dyslipidemia were enrolled and randomly allocated (ratio 1:1) to either the early statin group (received pitavastatin 4 mg/day from baseline) or the late statin group (received pitavastatin 4 mg/day from 3 weeks after the baseline). Optical coherence tomography was performed at baseline, 3-week, and 36-week follow-up to assess nonculprit coronary plaques in 53 patients.
RESULTS
Between baseline and 3-week follow-up, fibrous-cap thickness increased in the early statin group (140 μm [interquartile range (IQR):120 to 170 μm] to 160 μm [IQR: 130 to 190 μm]; p = 0.017), but decreased in the late statin group (135 μm [IQR: 110 to 183 μm] to 130 μm [IQR: 108 to 160 μm]; p = 0.020). The percentage of increase in fibrous-cap thickness between baseline and 3-week follow-up was significantly greater in the early statin group compared with the late statin group (8.3% [IQR: 0.0% to 21.4%] vs. -5.8% [IQR: -16.0% to 0.0%]; p < 0.001). Between baseline and 36-week follow-up, fibrous-cap thickness increased comparably in the 2 groups.
CONCLUSIONS
Early therapy with pitavastatin 4 mg/day for patients with ACS provided an increase in fibrous-cap thickness in coronary plaques during the first 3 weeks of follow-up and a further increase during 36 weeks of follow-up. The study was registered with UMIN Clinical Trial Registry (Effect of PitavaStatin on Coronary Fibrous-cap Thickness-Assessment by Fourier-Domain Optical CoheRence Tomography [ESCORT]; UMIN000002678).
中文翻译：
早期匹伐他汀治疗对急性冠脉综合征患者光学相干断层扫描评估的冠状动脉纤维帽厚度的影响：ESCORT研究。
目的本研究的目的是通过光学相干断层扫描技术评估早期他汀类药物治疗对急性冠脉综合征（ACS）患者冠状动脉斑块纤维帽厚度的影响。背景技术他汀类药物可有助于稳定冠状动脉斑块。方法这是一项前瞻性，随机，主动控制，单中心研究。ACS患者和未经治疗的血脂异常患者入组，并随机分配（比例1：1）至早期他汀类组（比基线水平接受pitavastatin 4 mg /天）或晚期他汀类组（自术后3周起接受pitavastatin 4 mg /天）。基准）。在基线，3周和36周的随访中进行了光学相干断层扫描，以评估53例患者的非罪犯冠状动脉斑块。结果在基线和3周的随访之间，早期他汀类药物组的纤维帽厚度增加（140μm[四分位间距（IQR）：120至170μm]至160μm[IQR：130-190μm]； p = 0.017），但在晚期他汀类药物组减少（ 135μm[IQR：110至183μm]至130μm[IQR：108至160μm； p ＝ 0.020）。早期他汀类药物组与基线他汀类药物组相比，在基线和3周随访之间纤维帽厚度增加的百分比明显更高（8.3％[IQR：0.0％至21.4％]对-5.8％[ IQR：-16.0％至0.0％]； p <0.001）。在基线和36周的随访之间，两组的纤维帽厚度均增加。结论ACS患者早期应用匹伐他汀4 mg / day的早期治疗在随访的前3周期间增加了冠状斑块的纤维帽厚度，在随访的36周期间进一步增加。
更新日期：2018-06-05
中文翻译：
早期匹伐他汀治疗对急性冠脉综合征患者光学相干断层扫描评估的冠状动脉纤维帽厚度的影响：ESCORT研究。
目的本研究的目的是通过光学相干断层扫描技术评估早期他汀类药物治疗对急性冠脉综合征（ACS）患者冠状动脉斑块纤维帽厚度的影响。背景技术他汀类药物可有助于稳定冠状动脉斑块。方法这是一项前瞻性，随机，主动控制，单中心研究。ACS患者和未经治疗的血脂异常患者入组，并随机分配（比例1：1）至早期他汀类组（比基线水平接受pitavastatin 4 mg /天）或晚期他汀类组（自术后3周起接受pitavastatin 4 mg /天）。基准）。在基线，3周和36周的随访中进行了光学相干断层扫描，以评估53例患者的非罪犯冠状动脉斑块。结果在基线和3周的随访之间，早期他汀类药物组的纤维帽厚度增加（140μm[四分位间距（IQR）：120至170μm]至160μm[IQR：130-190μm]； p = 0.017），但在晚期他汀类药物组减少（ 135μm[IQR：110至183μm]至130μm[IQR：108至160μm； p ＝ 0.020）。早期他汀类药物组与基线他汀类药物组相比，在基线和3周随访之间纤维帽厚度增加的百分比明显更高（8.3％[IQR：0.0％至21.4％]对-5.8％[ IQR：-16.0％至0.0％]； p <0.001）。在基线和36周的随访之间，两组的纤维帽厚度均增加。结论ACS患者早期应用匹伐他汀4 mg / day的早期治疗在随访的前3周期间增加了冠状斑块的纤维帽厚度，在随访的36周期间进一步增加。
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