All Title Author
Keywords Abstract


Effects of Pitavastatin on the Intima-Media Thickness of the Carotid Artery in Patients with Ischemic Stroke: The Pitavastatin Efficacy Study on Surrogate Markers and Imaging for Stroke (PESSMIST)

DOI: 10.4236/wjns.2014.44034, PP. 306-312

Keywords: Pitavastatin, Stroke, ECHO, IMT, Hyperlipidemia

Full-Text   Cite this paper   Add to My Lib

Abstract:

Pitavastatin is a strong statin that was developed in Japan. The clinical impact of pitavastatin treatment in patients with ischemic stroke has not been reported. We conducted a prospective, open label, clinical case-control study to determine the secondary preventive effects of pitavastatin for patients with cerebral infarction and hyperlipidemia. The pitavastatin group included 20 Japanese patients diagnosed with cerebral infarction and hyperlipidemia without previous statin intake. The control group included 22 patients diagnosed with cerebral infarction without hyperlipidemia. The pitavastatin group of patients received 2 mg of pitavastatin once a day after dinner. The mean age of the patients was 69.3 and 75.5 years for the pitavastatin and control groups, respectively, and the age of the pitavastatin group was significantly younger than that of the control group (P < 0.05). The serum TCho and LDL-C levels significantly decreased two months after the initiation of pitavastatin treatment. The mean and maximum intima-media thickness (IMT) also decreased after the initiation of pitavastatin. The mean and maximum IMT did not show any significant changes in the control group. The change of IMT %/year was less than zero for the pitavastatin group, and was almost zero or higher for the control group. Pitavastatin showed beneficial effects by improving the surrogate makers of stroke. These surrogate makers were effective to evaluate the efficacy of pitavastatin to prevent secondary stroke. Although a prospective randomized study is required to elucidate the long-term effects of pitavastatin, the current study suggests that pitavastatin may be effective to prevent secondary stroke in patients with stroke and hyperlipidemia.

References

[1]  De Caterina, R., Scarano, M., Marfisi, R., Lucisano, G., Palma, F., Tatasciore, A., et al. (2010) Cholesterol-Lowering Interventions and Stroke: Insights from a Meta-Analysis of Randomized Controlled Trials. Journal of the American College of Cardiology, 55, 198-211.
http://dx.doi.org/10.1016/j.jacc.2009.07.062
[2]  Imamura, T., Doi, Y., Arima, H., Yonemoto, K., Hata, J., Kubo, M., et al. (2009) LDL Cholesterol and the Development of Stroke Subtypes and Coronary Heart Disease in a General Japanese Population: The Hisayama Study. Stroke, 40, 382-388. http://dx.doi.org/10.1161/STROKEAHA.108.529537
[3]  O’Leary, D.H., Polak, J.F., Kronmal, R.A., Manolio, T.A., Burke, G.L. and Wolfson, S.K. (1999) Carotid-Artery Intima and Media Thickness as a Risk Factor for Myocardial Infarction and Stroke in Older Adults. New England Journal of Medicine, 340, 14-22. http://dx.doi.org/10.1056/NEJM199901073400103
[4]  Rosenson, R.S. (2000) Biological Basis for Statin Therapy in Stroke Prevention. Current Opinion in Neurology, 13, 57-62. http://dx.doi.org/10.1097/00019052-200002000-00011
[5]  Crouse, J.R., Raichlen, J.S., Riley, W.A., et al. (2007) Effect of Rosuvastatin on Progression of Carotid Intima-Media Thickness in Low-Risk Individuals with Subclinical Atherosclerosis: The Meteor Trial. JAMA, 297, 1344-1353.
http://dx.doi.org/10.1001/jama.297.12.1344
[6]  Nohara, R., Daida, H., Hata, M., Kaku, K., Kawamori, R., Kishimoto, J., et al. (2012) Effect of Intensive LipidLowering Therapy with Rosuvastatin on Progression of Carotid Intima-Media Thickness in Japanese Patients: Justification for Atherosclerosis Regression Treatment (JART) Study. Circulation Journal, 76, 221-229.
http://dx.doi.org/10.1253/circj.CJ-11-0887
[7]  Nohara, R., Daida, H., Hata, M., Kaku, K., Kawamori, R., Kishimoto, J., et al. (2013) Effect of Long-Term Intensive Lipid-Lowering Therapy with Rosuvastatin on Progression of Carotid Intima-Media Thickness—Justification for Atherosclerosis Regression Treatment (JART) Extension Study. Circulation Journal, 77, 1526-1533.
http://dx.doi.org/10.1253/circj.CJ-12-1149
[8]  Goldstein, L.B., Amarenco, P., LaMonte, M., Gilbert, S., Messig, M., Callahan, A., et al. (2008) Relative Effects of Statin Therapy on Stroke and Cardiovascular Events in Men and Women: Secondary Analysis of the Stroke Prevention by Aggressive Reduction in Cholesterol Levels (SPARCL) Study. Stroke, 39, 2444-2448.
http://dx.doi.org/10.1161/STROKEAHA.107.513747
[9]  Everett, B.M., Glynn, R.J., MacFadyen, J.G. and Ridker, P.M. (2010) Rosuvastatin in the Prevention of Stroke among Men and Women with Elevated Levels of C-Reactive Protein: Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER). Circulation, 121, 143-150.
http://dx.doi.org/10.1161/CIRCULATIONAHA.109.874834
[10]  Nakamura, H., Arakawa, K., Itakura, H., Kitabatake, A., Goto, Y., Toyota, T., et al. (2006) Primary Prevention of Cardiovascular Disease with Pravastatin in Japan (MEGA Study): A Prospective Randomised Controlled Trial. The Lancet, 368, 1155-1163. http://dx.doi.org/10.1016/S0140-6736(06)69472-5
[11]  Nakamura, T., Obata, J.-E., Kitta, Y., Takano, H., Kobayashi, T., Fujioka, D., et al. (2008) Rapid Stabilization of Vulnerable Carotid Plaque within 1 Month of Pitavastatin Treatment in Patients with Acute Coronary Syndrome. Journal of Cardiovascular Pharmacology, 51, 365-371.
http://dx.doi.org/10.1097/FJC.0b013e318165dcad
[12]  Takano, H., Mizuma, H., Kuwabara, Y., Sato, Y., Shindo, S., Kotooka, N., et al. (2013) Effects of Pitavastatin in Japanese Patients with Chronic Heart Failure: The Pitavastatin Heart Failure Study (PEARL Study). Circulation Journal, 77, 917-925. http://dx.doi.org/10.1253/circj.CJ-12-1062
[13]  Warita, S., Kawasaki, M., Tanaka, R., Ono, K., Kojima, T., Hirose, T., et al. (2012) Effects of Pitavastatin on Cardiac Structure and Function and on Prevention of Atrial Fibrillation in Elderly Hypertensive Patients: A Prospective Study of 2-Years’ Follow-Up. Circulation Journal, 76, 2755-2762.
http://dx.doi.org/10.1253/circj.CJ-12-0722
[14]  Ikeda, K., Takahashi, T., Yamada, H., Matsui, K., Sawada, T., Nakamura, T., et al. (2012) Effect of Intensive Statin Therapy on Regression of Carotid Intima-Media Thickness in Patients with Subclinical Carotid Atherosclerosis (a Prospective, Randomized Trial: PEACE (Pitavastatin Evaluation of Atherosclerosis Regression by Intensive Cholesterol-Lowering Therapy) Study. European Journal of Preventive Cardiology, 20, 1069-1079.
[15]  Saku, K., Zhang, B., Noda, K. and The PATROL Trial Investigators (2011) Randomized Head-to-Head Comparison of Pitavastatin, Atorvastatin, and Rosuvastatin for Safety and Efficacy (Quantity and Quality of LDL)—The PATROL Trial. Circulation Journal, 75, 1493-1505. http://dx.doi.org/10.1253/circj.CJ-10-1281
[16]  American Heart Association (1990) Special Report from the National Institute of Neurological Disorders and Stroke. Classification of Cerebrovascular Diseases III. Stroke, 21, 637-676.
http://dx.doi.org/10.1161/01.STR.21.4.637
[17]  Adams, H., Bendixen, B., Kappelle, L., Biller, J., Love, B., Gordon, D., et al. (1993) Classification of Subtype of Acute Ischemic Stroke. Definitions for Use in a Multicenter Clinical Trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment. Stroke, 24, 35-41. http://dx.doi.org/10.1161/01.STR.24.1.35
[18]  Prati, P., Tosetto, A., Casaroli, M., Bignamini, A., Canciani, L., Bornstein, N., et al. (2011) Carotid Plaque Morphology Improves Stroke Risk Prediction: Usefulness of a New Ultrasonographic Score. Cerebrovascular Diseases, 31, 300-304. http://dx.doi.org/10.1159/000320852
[19]  Ruiz-Ares, G., Fuentes, B., Martinez-Sanchez, P., Martinez-Martinez, M. and Diez-Tejedor, E. (2011) Utility of the Assessment of Echogenicity in the Identification of Symptomatic Carotid Artery Atheroma Plaques in Ischemic Stroke Patients. Cerebrovascular Diseases, 32, 535-541.
http://dx.doi.org/10.1159/000330654
[20]  Nomura, E., Kohriyama, T., Matsumoto, M. and Kobayashi, S. (2005) Clinical Characteristics of First-Ever Atherothrombotic Infarction or Lacunar Infarction with Hyperlipidemia (J-STARS-C): An Analysis of Data from the Stroke Data Bank of Japan. Internal Medicine, 44, 1252-1257.
http://dx.doi.org/10.2169/internalmedicine.44.1252
[21]  Amarenco, P., Labreuche, J., Lavallee, P. and Touboul, P.-J. (2004) Statins in Stroke Prevention and Carotid Atherosclerosis: Systematic Review and Up-to-Date Meta-Analysis. Stroke, 35, 2902-2909.
http://dx.doi.org/10.1161/01.STR.0000147965.52712.fa

Full-Text

comments powered by Disqus