Faculty Information |
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Article types | Original article |
Language | English |
Refereed paper | Refereed |
Title | Impact of Dual Lipid-Lowering Strategy With Ezetimibe and Atorvastatin on Coronary Plaque Regression in Patients With Percutaneous Coronary Intervention: The Multicenter Randomized Controlled PRECISE-IVUS Trial. |
Journal | Formal name:Journal of the American College of Cardiology Abbreviation:J Am Coll Cardiol ISSN code:1558-3597(Electronic)0735-1097(Linking) |
Volume, Number, Page | 66(5),pp.495-507 |
Papers・Author | Tsujita Kenichi, Sugiyama Seigo, Sumida Hitoshi, Shimomura Hideki, Yamashita Takuro, Yamanaga Kenshi, Komura Naohiro, Sakamoto Kenji, Oka Hideki, Nakao Koichi, Nakamura Sunao, Ishihara Masaharu, Matsui Kunihiko, Sakaino Naritsugu, Nakamura Natsuki, Yamamoto Nobuyasu, Koide Shunichi, Matsumura Toshiyuki, Fujimoto Kazuteru, Tsunoda Ryusuke, Morikami Yasuhiro, Matsuyama Koushi, Oshima Shuichi, Kaikita Koichi, Hokimoto Seiji, Ogawa Hisao, Ogawa Hisao |
Publication date | 2015/08 |
Papers・Description | BACKGROUND:Despite standard statin therapy, a majority of patients retain a highBACKGROUND:"BACKGROUND:residual riskBACKGROUND:"BACKGROUND:of cardiovascular events.OBJECTIVES:The aim of this study was to evaluate the effects of ezetimibe plus atorvastatin versus atorvastatin monotherapy on the lipid profile and coronary atherosclerosOBJECTIVES:is in Japanese patients who underwent percutaneous coronary intervention (PCI).METHODS:This trial was a prospective, randomized, controlled, multicenter study. Eligible patients who underwent PCI were randomly assigned to atorvastatin alone or atorvastatin plus ezetimibe (10 mg) daily. Atorvastatin was uptitrated with a treatment goal of low-density lipoprotein cholesterol (LDL-C) METHODS:<METHODS:70 mg/dl. Serial volumetric intravascular ultrasound was performed at baseline and again at 9 to 12 months to quantify the coronary plaque response in 202 patients.RESULTS:The combination of atorvastatin/ezetimibe resulted in lower levels of LDL-C than atorvastatin monotherapy (63.2 ± 16.3 mg/dl vs. 73.3 ± 20.3 mg/dl; p RESULTS:<RESULTS:0.001). For the absolute change in percent atheroma volume (PAV), the mean difference between the 2 groups (-1.538%; 95% confidence interval [CIRESULTS:]RESULTS:: -3.079% to 0.003%) did not exceed the pre-defined noninferiority margin of 3%, but the absolute change in PAV did show superiority for the dual lipid-lowering strategy (-1.4%; 95% CI: -3.4% to -0.1% vs. -0.3%; 95% CI: -1.9% to 0.9% with atorvastatin alone; p = 0.001). For PAV, a significantly greater percentage of patients who received atorvastatin/ezetimibe showed coronary plaque regression (78% vs. 58%; p = 0.004). Both strategies had acceptable side effect profiles, with a low incidence of laboratory abnormalities and cardiovascular events.CONCLUSIONS:Compared with standard statin monotherapy, the combination of statin plus ezetimibe showed greater coronary plaque regression, which might be attributed to cholesterol absorption inhibition- |
DOI | 10.1016/j.jacc.2015.05.065 |
PMID | 26227186 |