The highest dose of pitavastatin significantly decreased inflammatory cytokines and coronary neointimal hyperplasia during the 12-month follow-up in type 2 diabetic patients

초록

Background and Aims: 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. Methods: A total of 72 diabetic patients with NSTE-ACS were randomized to the lowest-dose pitavastatin (1mg [n=36]) or the highest-dose pitavastatin (4mg [n=36]) after everolimus-eluting stent implantation. Results: Neointimal volume was significantly lower in the pitavastatin 4mg group (0.41±0.28 mm3/1mm vs. 0.74±0.23 mm3/1mm, p<0.01) at 12-month follow-up. Improvement of brachial artery flow-mediated dilation (baFMD) was significantly higher in the pitavastatin 4mg group than in pitavastatin 1mg group (0.15±0.15 mm vs. -0.03±0.19 mm, p<0.001). Additionally, the improvement of adiponectin levels was significantly greater in the pitavastatin 4mg group than in the pitavastatin 1mg group (2.97±3.98 μg/mL vs. 0.59±2.80 μg/mL, p<0.05). Conclusions: Pitavastatin 4mg significantly improved inflammatory cytokines and lipid profiles compared to pitavastatin 1mg 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 4mg can be safely and effectively used in high-risk patients requiring coronary stenting.