Lower Level of Low-density Lipoprotein Cholesterol by Statin Prevents Progression of Coronary Restenosis after Successful Stenting in Acute Myocardial Infarction
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概要
- 論文の詳細を見る
Objective: It is unclear whether the reduction of coronary restenosis by statins is due to a decrease in low-density lipoprotein (LDL) cholesterol and/or pleiotropic effects. Therefore, we performed quantitative coronary angiography (QCA) and analyzed the lipid profile and changes in adhesion molecules and chemokines caused by statin in patients with acute myocardial infarction (AMI). Methods: The subjects included AMI patients who had initial coronary angiograms and significant coronary stenosis and were implanted with a stent. After stent implantation, patients were treated either with (n=36) or without (n=14) statin. The primary end-point for this study was the absolute changes in the lipid profile, C-reactive protein (CRP), adhesion molecules, chemokines and stenosis measured by QCA between the post-stent and follow-up angiogram at 6 months after stenting. Results: Treatment with statin reduced % coronary diameter stenosis (DS) and was associated with a greater reduction in LDL cholesterol at 6 months after stenting in patients with acute myocardial infarction (AMI), while there were no differences in adhesion molecules, chemokines, CC chemokine receptor or CXC chemokine receptor. Interestingly, changes in % DS between before and after statin treatment at 6 months (Δ%DS) were positively correlated with ΔLDL cholesterol, and patients who had an LDL cholesterol level of less than 80 mg/dl had a significantly lower Δ%DS. In addition, Δ%DS was significantly related only to the reduction in LDL cholesterol as assessed by a stepwise multivariable regression analysis. Conclusion: These results suggest that the lower level of LDL cholesterol is the most critical factor in preventing coronary restenosis.
著者
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SHIRAI Kazuyuki
Department of Cardiology, Fukuoka University Hospital
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Nishikawa Hiroaki
Department Of Cardiology Faculty Of Medicine Fukuoka University
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Shirai Kazuyuki
Department Of Cardiology Faculty Of Medicine Fukuoka University
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Tomita Sayo
Department Of Cardiology Fukuoka University School Of Medicine
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Matsuo Yoshino
Department Of Cardiology Fukuoka University School Of Medicine
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Kumagai Koichiro
Department Of 2nd Internal Medicine Fukuoka University
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Matsuo Kunihiro
Department Of Cardiology Fukuoka University Hospital School Of Medicine
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Kawamura Akira
Department Of Applied Electronics Faculty Of Electro-communications University Of Electro-communicat
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Saku Keijiro
Department Of Cardiology Faculty Of Medicine Fukuoka University
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Miura Shin-ichiro
Department Of Cardiology Faculty Of Medicine Fukuoka University
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Iwata Atsushi
Department Of Biological Sciences Stanford University
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Zhang Bo
Department Of Biochemistry Fukuoka University School Of Medicine
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KUMAGAI Koichiro
Department of Cardiology, Fukuoka University Hospital
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Miura Shin-ichiro
Department of Cardiology, Fukuoka University Hospital
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Kawamura Akira
Department of Cardiology, Fukuoka University Hospital
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Matsuo Yoshino
Department of Cardiology, Fukuoka University Hospital
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Tomita Sayo
Department of Cardiology, Fukuoka University Hospital
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