Rosuvastatin combined with ramipril significantly reduced atheroma volume by anti-inflammatory mechanism: Comparative analysis with rosuvastatin alone by intravascular ultrasound
International Journal of Cardiology, 06/12/2012
Han SH et al. – Rosuvastatin combined ramipril therapy significantly reduced atheroma volume that was related with anti–inflammatory effects.Methods
- Subjects were randomly assigned to 2 treatment groups (rosuvastatin alone group; 20mg/day, combined group; rosuvastatin 20mg/day and ramipril 10mg/day).
- Total atheroma volume per 10mm segment (TAV/10mm), percent atheroma volume per 10mm segment (PAV/10mm) in entire indexed segments and TAVmost10, PAVmost10 in a 10mm subsegment with the greatest disease by intravascular ultrasound, and lipids, metabolic parameters (adiponectin, insulin sensitivity), biomarkers (hsCRP, matrix metalloproteinase–9) were analyzed at baseline and at 9–12months follow–up.
- A total of 40 patients (rosuvastatin group; 21, combined group; 19), 46 lesions (rosuvastatin group; 24, combined group; 22) were finally analyzed.
- Rosuvastatin alone significantly reduced TAV/10mm (–7.8±17.4%, p<0.001) but did not change PAV/10mm, TAVmost10, PAVmost10 after therapy.
- In combined group, TAV/10mm, TAVmost10, PAVmost10 were significantly reduced after therapy (–10.7±11.5%, –13.4±14.5%, –2.7±5.8%, p<0.001, <0.001 and p=0.04) but PAV/10mm did not change.
- The magnitude of changes of all IVUS derived parameters did not differ significantly between 2 groups.
- Of interest, the most important factor for the changes of PAVmost10 was the percent changes of LDL cholesterol ( β=0.23, 95% CI [0.07–0.39], p=0.007) in rosuvastatin alone group and the changes in hsCRP (β=1.89, 95% CI [0.63–3.14], p=0.005) and baseline fasting blood glucose (β=0.06, 95% CI [0.01–0.11], p=0.02) in combined group by multivariate analysis.