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Development of a model for prediction of coronary atherosclerotic regression: evaluation of high-density lipoprotein cholesterol level and peripheral blood monocyte count

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Abstract

Monocytes and high-density lipoprotein cholesterol (HDL-C) play important roles in the process of coronary atherosclerosis. We hypothesized that a reasonable predictive model of coronary plaque regression might be constructed using the change in the peripheral monocyte count and the serum HDL-C level. The plaque volume, as assessed by volumetric intravascular ultrasound, was measured at the baseline and after 6 months of pravastatin therapy in 114 patients with coronary artery disease. After 6 months of pravastatin therapy, a significant decrease of the plaque volume by 9.9% (p < 0.0001, vs. baseline) was observed; furthermore, a corresponding increase of the serum HDL-C level and decrease of the peripheral blood monocyte count were also seen (12.5%, p < 0.01 and −7.3%, p < 0.0001). In a multivariate regression analysis using the serum lipids and traditional risk factors as the covariates, the increase in the serum HDL-C (β −0.56, p < 0.0001) and the decrease in monocyte count (β 0.23, p = 0.03) were identified as independent predictors of the plaque regression. A model for the prediction of plaque regression according to whether the achieved the change in (Δ) monocyte count and ΔHDL-C were above or below the median values was prepared. Among the four groups, the group with ΔHDL-C ≥8.8% and Δmonocyte count ≤−8.6% showed the largest plaque regression (−20.4%), and the group with ΔHDL-C <8.8% and Δmonocyte count >−8.6% showed the increase of the plaque volume (2.6%). In view of the inflammatory nature of atherosclerosis, the model constructed using the two predictors may be a useful model for the prediction of plaque regression.

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References

  1. Ross R (1999) Atherosclerosis—an inflammatory disease. N Engl J Med 340:115–126

    Article  PubMed  CAS  Google Scholar 

  2. Shah PK, Kaul S, Nilsson J, Cercek B (1999) Exploiting the vascular protective effects of high-density lipoprotein and its apolipoproteins: an idea whose time for testing is coming, part I. Circulation 104:2376–2383

    Article  Google Scholar 

  3. Ridker PM, Morrow DA, Rose LM, Rifai N, Cannon CP, Braunwald E (2005) Relative efficacy of atorvastatin 80 mg and pravastatin 40 mg in achieving the dual goals of low-density lipoprotein cholesterol <70 mg/dl and C-reactive protein <2 mg/l: an analysis of the PROVE-IT TIMI-22 trial. J Am Coll Cardiol 45:1644–1648

    Article  PubMed  CAS  Google Scholar 

  4. Gordon T, Castelli WP, Hjortland MC, Kannel WB, Dawber TR (1977) High-density lipoprotein as a protective factor against coronary heart disease. The Framingham Study. Am J Med 62:707–714

    Article  PubMed  CAS  Google Scholar 

  5. Tani S, Nagao K, Anazawa T, Kawamata H, Furuya S, Takahashi H, Iida K, Matsumoto M, Washio T, Kumabe N, Hirayama A (2009) Association of leukocyte subtype counts with coronary atherosclerotic regression following pravastatin treatment. Am J Cardiol 104:464–469

    Article  PubMed  CAS  Google Scholar 

  6. Tani S, Nagao K, Anazawa T, Kawamata H, Furuya S, Takahashi H, Iida K, Matsumoto M, Washio T, Kumabe N, Hirayama A (2010) Coronary plaque regression and lifestyle modification in patients treated with pravastatin. Circ J 74:954–961

    Article  PubMed  CAS  Google Scholar 

  7. Ishikawa K, Tani S, Watanabe I, Matsumoto M, Furukawa K, Nomoto K, Nomoto K, Kushiro T, Nagao K, Kanmatsuse K (2003) Effect of pravastatin on coronary plaque volume. Am J Cardiol 92:975–977

    Article  PubMed  CAS  Google Scholar 

  8. Chapman CM, Beilby JP, McQuillan BM, Thompson PL, Hung J (2004) Monocyte count, but not C-reactive protein or interleukin-6, is an independent risk marker for subclinical carotid atherosclerosis. Stroke 35:1619–1624

    Article  PubMed  CAS  Google Scholar 

  9. Bickel C, Rupprecht HJ, Blankenberg S, Espiniola-Klein C, Schlitt A, Rippin G, Hafner G, Treude R, Othman H, Hofmann KP, Meyer J, AtheroGene Investigators (2002) Relation of markers of inflammation (C-reactive protein, fibrinogen, von Willebrand factor, and leukocyte count) and statin therapy to long-term mortality in patients with angiographically proven coronary artery disease. Am J Cardiol 89:901–908

    Article  PubMed  CAS  Google Scholar 

  10. Nicholls SJ, Tuzcu EM, Sipahi I, Grasso AW, Schoenhagen P, Hu T, Wolski K, Crowe T, Desai MY, Hazen SL, Kapadia SR, Nissen SE (2007) Statins, high-density lipoprotein cholesterol, and regression of coronary atherosclerosis. JAMA 297:499–508

    Article  PubMed  CAS  Google Scholar 

  11. Takayama T, Hiro T, Yamagishi M, Daida H, Hirayama A, Saito S, Yamaguchi T, Matsuzaki M, Investigators COSMOS (2009) Effect of rosuvastatin on coronary atheroma in stable coronary artery disease: multicenter coronary atherosclerosis study measuring effects of rosuvastatin using intravascular ultrasound in Japanese subjects (COSMOS). Circ J 73:2110–2117

    Article  PubMed  CAS  Google Scholar 

  12. Tani S, Watanabe I, Anazawa T, Kawamata H, Tachibana E, Furukawa K, Sato Y, Nagao K, Kanmatsuse K, Kushiro T, Surugadai Atherosclerosis Regression Investigators (2005) Effect of pravastatin on malondialdehyde-modified low-density lipoprotein levels and coronary plaque regression as determined by three-dimensional intravascular ultrasound. Am J Cardiol 96:1089–1094

    Article  PubMed  CAS  Google Scholar 

  13. Tani S, Nagao K, Anazawa T, Kawamata H, Furuya S, Takahashi H, Iida K, Matsumoto M, Washio T, Kamabe N, Hirayama A (2010) Relation of change in the apolipoprotein B/apolipoprotein A-I ratio to coronary plaque regression following Pravastatin treatment in patients with coronary artery disease. Am J Cardiol 105:144–148

    Article  PubMed  CAS  Google Scholar 

  14. 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 110:1061–1068

    Article  PubMed  CAS  Google Scholar 

  15. Hirayama A, Saito S, Ueda Y, Takayama T, Honye J, Komatsu S, Yamaguchi O, Li Y, Yajima J, Nanto S, Takazawa K, Kodama K (2009) Qualitative and quantitative changes in coronary plaque associated with atorvastatin therapy. Circ J 73:718–725

    Article  PubMed  CAS  Google Scholar 

  16. Jia X, Wei M, Fu X, Gu X, Fan W, Zhang J, Xue L (2009) Intensive cholesterol-lowering therapy improves large artery elasticity in acute myocardial infarction patients. Heart Vessels 24:340–346

    Article  PubMed  Google Scholar 

  17. Suzuki T, Nozawa T, Fujii N, Sobajima M, Ohori T, Shida T, Matsuki A, Kameyama T, Inoue H (2010) Plaque regression in one artery is not necessarily associated with parallel changes in other vascular beds. Heart Vessels. doi:10.1007/s00380-010-0049-5

  18. Nicholls SJ, Hsu A, Wolski K, Hu B, Bayturan O, Lavoie A, Uno K, Tuzcu EM, Nissen SE (2010) Intravascular ultrasound-derived measures of coronary atherosclerotic plaque burden and clinical outcome. J Am Coll Cardiol 55:2399–2407

    Article  PubMed  Google Scholar 

  19. Hiro T, Kimura T, Morimoto T, Miyauchi K, Nakagawa Y, Yamagishi M, Ozaki Y, Kimura K, Saito S, Yamaguchi T, Daida H, Matsuzaki M, JAPAN-ACS Investigators (2009) Effect of intensive statin therapy on regression of coronary atherosclerosis in patients with acute coronary syndrome: a multicenter randomized trial evaluated by volumetric intravascular ultrasound using pitavastatin versus atorvastatin (JAPAN-ACS [Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome] Study). J Am Coll Cardiol 54(4):293–302

  20. Nissen SE, Tuzcu EM, Schoenhagen P, Crowe T, Sasiela WJ, Tsai J, Orazem J, Magorien RD, O’Shaughnessy C, Ganz P, Reversal of Atherosclerosis with Aggressive Lipid Lowering (REVERSAL) Investigators (2005) Statin therapy, LDL cholesterol, C-reactive protein, and coronary artery disease. N Engl J Med 352:29–38

    Article  PubMed  CAS  Google Scholar 

  21. Nissen SE, Nicholls SJ, Sipahi I, Libby P, Raichlen JS, Ballantyne CM, Davignon J, Erbel R, Fruchart JC, Tardif JC, Schoenhagen P, Crowe T, Cain V, Wolski K, Goormastic M, ASTEROID Tuzcu EM Investigators (2006) Effect of very high-intensity statin therapy on regression of coronary atherosclerosis: the ASTEROID trial. JAMA 295:1556–1565

    Article  PubMed  CAS  Google Scholar 

  22. Nakamura H, Arakawa K, Itakura H, Kitabatake A, Goto Y, Toyota T, Nakaya N, Nishimoto S, Muranaka M, Yamamoto A, Mizuno K, Ohashi Y, MEGA Study Group (2006) Primary prevention of cardiovascular disease with pravastatin in Japan (MEGA Study): a prospective randomised controlled trial. Lancet 368:1155–1163

    Article  PubMed  CAS  Google Scholar 

  23. Matsuzawa Y, Kita T, Shepherd J, Gotto AM Jr, Nakamura H, Sacks FM, Oikawa S, Sasaki J (2007) A trilogy of primary prevention statin trials. Panel discussion. Atheroscler Suppl 8:19–24

    Article  PubMed  CAS  Google Scholar 

  24. Tunstall-Pedoe H, Kuulasmaa K, Amouyel P, Arveiler D, Rajakangas AM, Pajak A (1994) Myocardial infarction and coronary deaths in the World Health Organization MONICA Project. Registration procedures, event rates, and case-fatality rates in 38 populations from 21 countries in four continents. Circulation 90:583–612

    PubMed  CAS  Google Scholar 

  25. Ueshima H (2007) Explanation for the Japanese paradox: prevention of increase in coronary heart disease and reduction in stroke. J Atheroscler Thromb 14:278–286

    Article  PubMed  Google Scholar 

  26. Nishizato Y, Ieiri I, Suzuki H, Kimura M, Kawabata K, Hirota T, Takane H, Irie S, Kusuhara H, Urasaki Y, Urae A, Higuchi S, Otsubo K, Sugiyama Y (2003) Polymorphisms of OATP-C (SLC21A6) and OAT3 (SLC22A8) genes: consequences for pravastatin pharmacokinetics. Clin Pharmacol Ther 73:554–565

    Article  PubMed  CAS  Google Scholar 

  27. Tirona RG (2005) Ethnic differences in statin disposition. Clin Pharmacol Ther 78:311–316

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Cardiology, Nihon University Surugadai Hospital, 1-8-13 Kanda-Surugadai, Chiyoda-ku, Tokyo, 101-8309, Japan

    Shigemasa Tani, Michiaki Matsumoto, Takeo Anazawa, Hirofumi Kawamata, Shingo Furuya, Hiroshi Takahashi, Kiyoshi Iida, Takehiko Washio, Narimichi Kumabe, Masashi Kobori & Ken Nagao

  2. Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan

    Shigemasa Tani, Michiaki Matsumoto, Takeo Anazawa, Hirofumi Kawamata, Shingo Furuya, Hiroshi Takahashi, Kiyoshi Iida, Takehiko Washio, Narimichi Kumabe, Masashi Kobori, Ken Nagao & Atsushi Hirayama

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  1. Shigemasa Tani
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  2. Michiaki Matsumoto
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  3. Takeo Anazawa
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  4. Hirofumi Kawamata
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  5. Shingo Furuya
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  6. Hiroshi Takahashi
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  7. Kiyoshi Iida
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  8. Takehiko Washio
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  9. Narimichi Kumabe
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  10. Masashi Kobori
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  11. Ken Nagao
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  12. Atsushi Hirayama
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Correspondence to Shigemasa Tani.

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Tani, S., Matsumoto, M., Anazawa, T. et al. Development of a model for prediction of coronary atherosclerotic regression: evaluation of high-density lipoprotein cholesterol level and peripheral blood monocyte count. Heart Vessels 27, 143–150 (2012). https://doi.org/10.1007/s00380-011-0130-8

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  • DOI: https://doi.org/10.1007/s00380-011-0130-8

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