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Early statin treatment in patients with acute coronary syndrome: demonstration of the beneficial effect on atherosclerotic lesions by serial volumetric intravascular ultrasound analysis during half a year after coronary event: the ESTABLISH Study.
Circulation. 2004 Aug 31; 110(9):1061-8.Circ

Abstract

BACKGROUND

Recent clinical trials have demonstrated that aggressive lipid lowering by statins could prevent recurrent events after acute coronary syndrome (ACS). We hypothesized that this efficacy was caused by a significant reduction in plaque volume by aggressive LDL cholesterol (LCL-C) lowering. The present study investigated the effect of early statin treatment on plaque volume of a nonculprit lesion by serial volumetric intravascular ultrasound in patients with ACS.

METHODS AND RESULTS

Seventy patients with ACS were enrolled. All patients underwent emergency coronary angiography and percutaneous coronary intervention (PCI). They were randomized to intensive lipid-lowering therapy (n=35; atorvastatin 20 mg/d) or control (n=35) groups after PCI. Volumetric intravascular ultrasound analyses were performed at baseline and 6-month follow-up for a non-PCI site in 48 patients (atorvastatin, n=24; control, n=24). LDL-C level was significantly decreased by 41.7% in the atorvastatin group compared with the control group, in which LDL-C was increased by 0.7% (P<0.0001). Plaque volume was significantly reduced in the atorvastatin group (13.1+/-12.8% decrease) compared with the control group (8.7+/-14.9% increase; P<0.0001). Percent change in plaque volume showed a significant positive correlation with follow-up LDL-C level (R=0.456, P=0.0011) and percent LDL-C reduction (R=0.612, P<0.0001), even in patients with baseline LDL-C <125 mg/dL.

CONCLUSIONS

Early aggressive lipid-lowering therapy by atorvastatin for 6 months significantly reduced the plaque volume in patients with ACS. Percent change in plaque volume showed a significant positive correlation with percent LDL-C reduction, even in patients with low baseline LDL-C.

Authors+Show Affiliations

Department of Cardiology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku Tokyo 113-8421 Japan. shinya@med.juntendo.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

15326073

Citation

Okazaki, Shinya, et al. "Early Statin Treatment in Patients With Acute Coronary Syndrome: Demonstration of the Beneficial Effect On Atherosclerotic Lesions By Serial Volumetric Intravascular Ultrasound Analysis During Half a Year After Coronary Event: the ESTABLISH Study." Circulation, vol. 110, no. 9, 2004, pp. 1061-8.
Okazaki S, Yokoyama T, Miyauchi K, et al. Early statin treatment in patients with acute coronary syndrome: demonstration of the beneficial effect on atherosclerotic lesions by serial volumetric intravascular ultrasound analysis during half a year after coronary event: the ESTABLISH Study. Circulation. 2004;110(9):1061-8.
Okazaki, S., Yokoyama, T., Miyauchi, K., Shimada, K., Kurata, T., Sato, H., & Daida, H. (2004). Early statin treatment in patients with acute coronary syndrome: demonstration of the beneficial effect on atherosclerotic lesions by serial volumetric intravascular ultrasound analysis during half a year after coronary event: the ESTABLISH Study. Circulation, 110(9), 1061-8.
Okazaki S, et al. Early Statin Treatment in Patients With Acute Coronary Syndrome: Demonstration of the Beneficial Effect On Atherosclerotic Lesions By Serial Volumetric Intravascular Ultrasound Analysis During Half a Year After Coronary Event: the ESTABLISH Study. Circulation. 2004 Aug 31;110(9):1061-8. PubMed PMID: 15326073.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Early statin treatment in patients with acute coronary syndrome: demonstration of the beneficial effect on atherosclerotic lesions by serial volumetric intravascular ultrasound analysis during half a year after coronary event: the ESTABLISH Study. AU - Okazaki,Shinya, AU - Yokoyama,Takayuki, AU - Miyauchi,Katsumi, AU - Shimada,Kazunori, AU - Kurata,Takeshi, AU - Sato,Hitoshi, AU - Daida,Hiroyuki, Y1 - 2004/08/23/ PY - 2004/8/25/pubmed PY - 2005/3/26/medline PY - 2004/8/25/entrez SP - 1061 EP - 8 JF - Circulation JO - Circulation VL - 110 IS - 9 N2 - BACKGROUND: Recent clinical trials have demonstrated that aggressive lipid lowering by statins could prevent recurrent events after acute coronary syndrome (ACS). We hypothesized that this efficacy was caused by a significant reduction in plaque volume by aggressive LDL cholesterol (LCL-C) lowering. The present study investigated the effect of early statin treatment on plaque volume of a nonculprit lesion by serial volumetric intravascular ultrasound in patients with ACS. METHODS AND RESULTS: Seventy patients with ACS were enrolled. All patients underwent emergency coronary angiography and percutaneous coronary intervention (PCI). They were randomized to intensive lipid-lowering therapy (n=35; atorvastatin 20 mg/d) or control (n=35) groups after PCI. Volumetric intravascular ultrasound analyses were performed at baseline and 6-month follow-up for a non-PCI site in 48 patients (atorvastatin, n=24; control, n=24). LDL-C level was significantly decreased by 41.7% in the atorvastatin group compared with the control group, in which LDL-C was increased by 0.7% (P<0.0001). Plaque volume was significantly reduced in the atorvastatin group (13.1+/-12.8% decrease) compared with the control group (8.7+/-14.9% increase; P<0.0001). Percent change in plaque volume showed a significant positive correlation with follow-up LDL-C level (R=0.456, P=0.0011) and percent LDL-C reduction (R=0.612, P<0.0001), even in patients with baseline LDL-C <125 mg/dL. CONCLUSIONS: Early aggressive lipid-lowering therapy by atorvastatin for 6 months significantly reduced the plaque volume in patients with ACS. Percent change in plaque volume showed a significant positive correlation with percent LDL-C reduction, even in patients with low baseline LDL-C. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/15326073/Early_statin_treatment_in_patients_with_acute_coronary_syndrome:_demonstration_of_the_beneficial_effect_on_atherosclerotic_lesions_by_serial_volumetric_intravascular_ultrasound_analysis_during_half_a_year_after_coronary_event:_the_ESTABLISH_Study_ L2 - https://www.ahajournals.org/doi/10.1161/01.CIR.0000140261.58966.A4?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -