Heart and Vessels

, Volume 34, Issue 1, pp 62–73 | Cite as

Effects of lowest-dose vs. highest-dose pitavastatin on coronary neointimal hyperplasia at 12-month follow-up in type 2 diabetic patients with non-ST elevation acute coronary syndrome: an optical coherence tomography analysis

  • Jung Wook Lim
  • Han Saem Jeong
  • Soon Jun HongEmail author
  • Hyo Jeong Kim
  • Young Chan Kim
  • Bong Gyun Kang
  • Su Min Jeon
  • Jae Young Cho
  • Seung Hoon Lee
  • Hyung Joon Joo
  • Jae Hyoung Park
  • Cheol Woong Yu
Original Article


Current ACC/AHA guidelines recommend high-dose statin therapy after coronary stenting, especially in diabetic patients; however, pitavastatin 4 mg or pitavastatin 1 mg are frequently used after coronary stenting in Asia, even in patients with acute coronary syndrome. We compared the effects of highest-dose and lowest-dose pitavastatin therapy on coronary neointimal hyperplasia at 12-month follow-up in diabetic patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) using optical coherence tomography. A total of 72 diabetic patients with NSTE-ACS were randomized to lowest-dose pitavastatin [1 mg (n = 36)] or highest-dose pitavastatin [4 mg (n = 36)] after everolimus-eluting stent implantation. The primary endpoint was to compare the normalized neointimal volume at 12-month follow-up. Normalized neointimal volume was significantly lower in the pitavastatin 4 mg group (4.00 ± 2.80 vs. 8.24 ± 2.83 mm3/mm, p < 0.01) at 12-month follow-up. There was also significant difference in neointimal area between the pitavastatin 4 mg group and pitavastatin 1 mg group (0.41 ± 0.28 vs. 0.74 ± 0.23 mm2, p < 0.01). Improvement of brachial artery flow-mediated dilation (baFMD) was significantly higher in the pitavastatin 4 mg group than in pitavastatin 1 mg group (0.15 ± 0.15 vs. − 0.03 ± 0.19 mm, p < 0.001). In addition, the improvement of adiponectin levels was significantly greater in the pitavastatin 4 mg group than in the pitavastatin 1 mg group (2.97 ± 3.98 vs. 0.59 ± 2.80 μg/mL, p < 0.05). Pitavastatin 4 mg significantly improved inflammatory cytokines and lipid profiles compared to pitavastatin 1 mg during the 12-month follow-up, contributing to the reduction of neointimal hyperplasia and to the improvement of baFMD in diabetic patients with NSTE-ACS requiring coronary stenting. Thus, the administration of pitavastatin 4 mg can be safely and effectively used in high-risk patients requiring coronary stenting.

Trial registration NCT02545231 (Clinical Trial registration information:


Acute coronary syndrome Diabetic patients Pitavastatin Optical coherence tomography 



This research was supported by the Bio & Medical Technology Development Program of the National Research Foundation (NRF) funded by the Ministry of Science & ICT (No. NRF-2018M3A9A8017949), and by a grant of the Basic Science Research Program through the NRF funded by the Ministry of Education (No. NRF-2017R1D1A1B03034512), Republic of Korea.

Compliance with ethical standards

Conflict of interest

None of the authors have conflict of interest to declare.


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Copyright information

© Springer Japan KK, part of Springer Nature 2018

Authors and Affiliations

  • Jung Wook Lim
    • 1
  • Han Saem Jeong
    • 1
  • Soon Jun Hong
    • 1
    Email author
  • Hyo Jeong Kim
    • 1
  • Young Chan Kim
    • 1
  • Bong Gyun Kang
    • 1
  • Su Min Jeon
    • 1
  • Jae Young Cho
    • 1
  • Seung Hoon Lee
    • 1
  • Hyung Joon Joo
    • 1
  • Jae Hyoung Park
    • 1
  • Cheol Woong Yu
    • 1
  1. 1.Department of Cardiology, Cardiovascular CenterKorea University Anam HospitalSeoulRepublic of Korea

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