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The effects of ezetimibe on coronary plaque volume in patients with stable angina pectoris previously treated with statins

Session Poster session 1

Speaker Associate Professor Atsushi Katoh

Event : ESC Congress 2017

  • Topic : coronary artery disease, acute coronary syndromes, acute cardiac care
  • Sub-topic : Coronary Artery Disease (Chronic)
  • Session type : Poster Session

Authors : A Katoh (Kurume,JP), Y Hattori (Kurume,JP), N Yoshikwa (Kurume,JP), H Niiyama (Kurume,JP), H Harada (Kurume,JP), H Kai (Kurume,JP), H Ikeda (Omuta,JP)

A. Katoh1 , Y. Hattori1 , N. Yoshikwa1 , H. Niiyama1 , H. Harada1 , H. Kai1 , H. Ikeda2 , 1Kurume University Medical Center - Kurume - Japan , 2Faculty of Fukuoka Medical Technology, Teikyo University, Physical Therqapy - Omuta - Japan ,

European Heart Journal ( 2017 ) 38 ( Supplement ), 188

Statins prevents morbidity and mortality of cardiovascular diseases. But some residual risks remain even after statins' therapy. Recently, new cholesterol absorption inhibitor, ezetimibe has been shown to lower LDL cholesterol levels effectively. But it is not clear that ezetimibe's effects would be different from those of statins' when the LDL cholesterol levels are comparable. Therefore we investigated the effects of ezetimibe on coronary plaque volume and clinical outcome compared with statins among patients with stable angina pectoris (SAP). Thirty-three SAP patients receiving PCI therapy previously treated with statins were enrolled into the study. Patients were divided into two groups, one was statin group (n=17) that patients were treated with incremental dose of statin only. The other was ezetimibe group (n=16) that patients were administrated 10 mg ezetimibe added to previous treated statins. Baseline and after 9 months, subjects received intravascular ultrasound study and their clinical outcomes were examined during 3 years. LDL cholesterol significantly decreased in both group to comparable levels (from 101±27 to 80±16 mg/dL in statin group, from 111±27 to 72±18 mg/dL in ezetimibe group). Coronary artery plaque volume significantly decreased in ezetimibe group (from 71±25 to 67±25 mm3) not in statin group (from 66±16 to 69±16 mm3). Changes in coronary plaque volume in ezetimibe group significantly greater than those of statin group. (Figure) Ezetimibe treatment significantly decreased triglyceride, remnat-like lipoprotein, Apo B48 lipoprotein, campesterol, and sitosterol levels, while incremental statin therapy didn't. Clinical follow-up revealed only 3 cardiovascular events in ezetimibe group, while 7 cardiovascular events occurred in statin group.

These results indicates that ezetimibe treatment adding to statin could decrease coronary artery plaque volume beyond LDL cholesterol lowering effects and would have clinical benefits compared with incremental statin therapy.


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