Predictors of Plaque Progression in Hypertensive Angina Patients with Achieved Low-Density Lipoprotein Cholesterol Less Than 70 mg/dL after Rosuvastatin Treatment
10.4068/cmj.2015.51.3.120
- Author:
Young Joon HONG
1
;
Myung Ho JEONG
;
Min Chul KIM
;
Woo Jin KIM
;
Hyun Kuk KIM
;
Keun Ho PARK
;
Doo Sun SIM
;
Ju Han KIM
;
Youngkeun AHN
;
Jeong Gwan CHO
;
Jong Chun PARK
Author Information
1. Division of Cardiology, Chonnam National University Hospital, Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea. myungho@chollian.net
- Publication Type:Original Article
- Keywords:
Coronary disease;
Hypertension;
Plaque;
Lipids;
Ultrasonography, Interventional
- MeSH:
Apolipoproteins;
Cholesterol;
Coronary Disease;
Follow-Up Studies;
Humans;
Hydroxymethylglutaryl-CoA Reductase Inhibitors;
Hypertension;
Lipoproteins;
Prevalence;
Renal Insufficiency, Chronic;
Smoke;
Smoking;
Ultrasonography;
Ultrasonography, Interventional;
Rosuvastatin Calcium
- From:Chonnam Medical Journal
2015;51(3):120-128
- CountryRepublic of Korea
- Language:English
-
Abstract:
We evaluated the impact of achieved low-density lipoprotein cholesterol (LDL-C) concentrations <70 mg/dL on plaque progression in statin-treated hypertensive angina patients by use of virtual histology-intravascular ultrasound (VH-IVUS). The effects of 10 mg of rosuvastatin on plaque progression were evaluated in 78 patients who achieved LDL-C <70 mg/dL with statin treatment. The patients were divided into plaque progressors (n=30) and plaque regressors (n=40) on the basis of the baseline minimum lumen area (MLA) site at the 9-month follow-up. The prevalence of chronic kidney disease (CKD) [creatinine clearance (CrCl) <60 mL/min)] and current smoking was higher in progressors than in regressors (90.0% vs. 31.3%, p<0.001, and 40.0% vs. 12.5%, p=0.005, respectively). Baseline CrCl was significantly lower and baseline apolipoprotein (apo) B/A1 was significantly higher in progressors than in regressors (21+/-13 mL/min vs. 70+/-20 mL/min, p<0.001, and 0.77+/-0.23 vs. 0.65+/-0.16, p=0.011, respectively). Absolute and relative fibrotic areas at the MLA site increased in progressors; by contrast, these areas decreased in regressors from baseline to follow-up. CKD [odds ratio (OR): 2.13, 95% confidence interval (CI): 1.77-2.53, p=0.013], smoking (OR: 1.76, 95% CI: 1.23-2.22, p=0.038), and apoB/A1 (OR: 1.25, 95% CI: 1.12-1.40, p=0.023), but not any VH-IVUS parameters, were independent predictors of plaque progression at follow-up. In conclusion, clinical factors including CKD, smoking, and apoB/A1 rather than plaque components detected by VH-IVUS are associated with plaque progression in hypertensive angina patients who achieve very low LDL-C after statin treatment.
