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Lipoprotein(a) is associated with necrotic core progression of non-culprit coronary lesions in statin-treated patients with angina pectoris.

Nozue T, Yamamoto S, Tohyama S, Fukui K, Umezawa S, Onishi Y, Kunishima T, Sato A, Nozato T, Miyake S, Takeyama Y, Morino Y, Yamauchi T, Muramatsu T, Hibi K, Terashima M, Michishita I - Lipids Health Dis (2014)

Bottom Line: However, statin therapy does not effectively halt the accumulation of necrotic core in all patients.Multivariate logistic regression analysis showed that Lp(a) was a significant independent predictor associated with necrotic core progression during statin therapy (odds ratio [OR]: 3.514; 95% confidence interval [CI]: 1.338-9.228; p = 0.01).Serum Lp(a) is independently associated with necrotic core progression in statin-treated patients with angina pectoris.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Cardiology, Department of Internal Medicine, Yokohama Sakae Kyosai Hospital, 132 Katsura-cho, Sakae-ku, Yokohama 247-8581, Japan. nozue2493@yahoo.co.jp.

ABSTRACT

Background: Statin therapy results in regression and stabilization of coronary artery plaques, and reduces the incidence of coronary artery disease. However, statin therapy does not effectively halt the accumulation of necrotic core in all patients. The purpose of the present study was to identify the predictors associated with necrotic core progression during statin therapy.

Methods: Coronary atherosclerosis in non-culprit lesions was evaluated using virtual histology intravascular ultrasound at baseline and 8 months after statin therapy. One hundred nineteen patients were divided into 2 groups based on necrotic core progression or regression during an 8-month follow-up period.

Results: Patients with necrotic core progression had higher serum lipoprotein(a) [Lp(a)] levels than patients with regression at baseline (16 mg/dL vs. 12 mg/dL, p = 0.02) and at the 8-month follow-up (17 mg/dL vs. 10 mg/dL, p = 0.006). Patients with necrotic core progression had a higher fibro-fatty plaque volume (1.28 mm³/mm vs. 0.73 mm³/mm, p = 0.002), and less necrotic core (0.56 mm³/mm vs. 1.04 mm³/mm, p < 0.0001) and dense calcium (0.35 mm³/mm vs. 0.56 mm³/mm, p = 0.006) plaque volumes at baseline than patients with regression. Multivariate logistic regression analysis showed that Lp(a) was a significant independent predictor associated with necrotic core progression during statin therapy (odds ratio [OR]: 3.514; 95% confidence interval [CI]: 1.338-9.228; p = 0.01).

Conclusions: Serum Lp(a) is independently associated with necrotic core progression in statin-treated patients with angina pectoris.

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Related in: MedlinePlus

Representative intravascular ultrasound images of necrotic core progression. Fibrous areas were marked in green, fibro-fatty in yellow, dense calcium in white, and necrotic core in red on the virtual histology intravascular ultrasound image. This case was a 71-year-old male patient with unstable angina pectoris treated with pravastatin. His baseline serum lipoprotein(a) level was 47 mg/dL. A greater increase in the necrotic core area was observed at the 8-month follow-up.
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Figure 1: Representative intravascular ultrasound images of necrotic core progression. Fibrous areas were marked in green, fibro-fatty in yellow, dense calcium in white, and necrotic core in red on the virtual histology intravascular ultrasound image. This case was a 71-year-old male patient with unstable angina pectoris treated with pravastatin. His baseline serum lipoprotein(a) level was 47 mg/dL. A greater increase in the necrotic core area was observed at the 8-month follow-up.

Mentions: The representative IVUS images are shown in Figures 1 and 2. Figure 1 shows IVUS images of a 71-year-old male patient with unstable angina pectoris whose baseline serum Lp(a) level was 47 mg/dL. A greater increase in the necrotic core area was observed at the 8-month follow-up. Figure 2 shows IVUS images of a 78-year-old male patient with stable angina pectoris whose baseline serum Lp(a) level was 3 mg/dL. A greater reduction of the necrotic core area was observed at the 8-month follow-up.


Lipoprotein(a) is associated with necrotic core progression of non-culprit coronary lesions in statin-treated patients with angina pectoris.

Nozue T, Yamamoto S, Tohyama S, Fukui K, Umezawa S, Onishi Y, Kunishima T, Sato A, Nozato T, Miyake S, Takeyama Y, Morino Y, Yamauchi T, Muramatsu T, Hibi K, Terashima M, Michishita I - Lipids Health Dis (2014)

Representative intravascular ultrasound images of necrotic core progression. Fibrous areas were marked in green, fibro-fatty in yellow, dense calcium in white, and necrotic core in red on the virtual histology intravascular ultrasound image. This case was a 71-year-old male patient with unstable angina pectoris treated with pravastatin. His baseline serum lipoprotein(a) level was 47 mg/dL. A greater increase in the necrotic core area was observed at the 8-month follow-up.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4230650&req=5

Figure 1: Representative intravascular ultrasound images of necrotic core progression. Fibrous areas were marked in green, fibro-fatty in yellow, dense calcium in white, and necrotic core in red on the virtual histology intravascular ultrasound image. This case was a 71-year-old male patient with unstable angina pectoris treated with pravastatin. His baseline serum lipoprotein(a) level was 47 mg/dL. A greater increase in the necrotic core area was observed at the 8-month follow-up.
Mentions: The representative IVUS images are shown in Figures 1 and 2. Figure 1 shows IVUS images of a 71-year-old male patient with unstable angina pectoris whose baseline serum Lp(a) level was 47 mg/dL. A greater increase in the necrotic core area was observed at the 8-month follow-up. Figure 2 shows IVUS images of a 78-year-old male patient with stable angina pectoris whose baseline serum Lp(a) level was 3 mg/dL. A greater reduction of the necrotic core area was observed at the 8-month follow-up.

Bottom Line: However, statin therapy does not effectively halt the accumulation of necrotic core in all patients.Multivariate logistic regression analysis showed that Lp(a) was a significant independent predictor associated with necrotic core progression during statin therapy (odds ratio [OR]: 3.514; 95% confidence interval [CI]: 1.338-9.228; p = 0.01).Serum Lp(a) is independently associated with necrotic core progression in statin-treated patients with angina pectoris.

View Article: PubMed Central - HTML - PubMed

Affiliation: Division of Cardiology, Department of Internal Medicine, Yokohama Sakae Kyosai Hospital, 132 Katsura-cho, Sakae-ku, Yokohama 247-8581, Japan. nozue2493@yahoo.co.jp.

ABSTRACT

Background: Statin therapy results in regression and stabilization of coronary artery plaques, and reduces the incidence of coronary artery disease. However, statin therapy does not effectively halt the accumulation of necrotic core in all patients. The purpose of the present study was to identify the predictors associated with necrotic core progression during statin therapy.

Methods: Coronary atherosclerosis in non-culprit lesions was evaluated using virtual histology intravascular ultrasound at baseline and 8 months after statin therapy. One hundred nineteen patients were divided into 2 groups based on necrotic core progression or regression during an 8-month follow-up period.

Results: Patients with necrotic core progression had higher serum lipoprotein(a) [Lp(a)] levels than patients with regression at baseline (16 mg/dL vs. 12 mg/dL, p = 0.02) and at the 8-month follow-up (17 mg/dL vs. 10 mg/dL, p = 0.006). Patients with necrotic core progression had a higher fibro-fatty plaque volume (1.28 mm³/mm vs. 0.73 mm³/mm, p = 0.002), and less necrotic core (0.56 mm³/mm vs. 1.04 mm³/mm, p < 0.0001) and dense calcium (0.35 mm³/mm vs. 0.56 mm³/mm, p = 0.006) plaque volumes at baseline than patients with regression. Multivariate logistic regression analysis showed that Lp(a) was a significant independent predictor associated with necrotic core progression during statin therapy (odds ratio [OR]: 3.514; 95% confidence interval [CI]: 1.338-9.228; p = 0.01).

Conclusions: Serum Lp(a) is independently associated with necrotic core progression in statin-treated patients with angina pectoris.

Show MeSH
Related in: MedlinePlus