Effects of Statins on the Epicardial Fat Thickness in Patients with Coronary Artery Stenosis Underwent Percutaneous Coronary Intervention: Comparison of Atorvastatin with Simvastatin/Ezetimibe
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Background: Epicardial fat is a visceral thoracic fat and known to be related with presence of dyslipidemia and coronary arterial stenosis. We evaluated the effects and differences of statins on epicardial fat thickness (EFT) in patients underwent successful percutaneous coronary intervention (PCI). Methods: In this retrospective cohort study, we enrolled consecutive patients underwent successful PCI and scheduled six to eight-months follow-up coronary angiography from March 2007 to June 2009. EFT was measured by echocardiography twice at the time of PCI and the follow-up coronary angiography. We included 145 patients (58 females; mean, 63.5 ± 9.5 years). Results: Of the 145 patients, 82 received 20 mg of atorvastatin (atorvastatin group) and 63 medicated with 10 mg of simvastatin with 10 mg of ezetimibe (simvastatin/ezetimibe group). With statin treatments, total cholesterol concentration (189.1 ± 36.1 to 143.3 ± 36.5 mg/dL, p < 0.001), triglycerides (143.5 ± 65.5 to 124.9 ± 63.1 mg/dL, p = 0.005), low density lipoprotein-cholesterol (117.4 ± 32.5 to 76.8 ± 30.9 mg/dL, p < 0.001) and EFT (4.08 ± 1.37 to 3.76 ± 1.29 mm, p < 0.001)were significantly decreased. Atorvastatin and simvastatin/ezetimibe showed similar improvements in the cholesterol profiles. However, atorvastatin decreased EFT more significantly than simvastatin/ezetimibe (EFT change 0.47 ± 0.65 in the atorvastatin vs. 0.12 ± 0.52 mm in the simvastatin/ezetimibe group; p = 0.001). Conclusion: In this study, the atorvastatin group showed significant reduction in EFT than in the simvastatin/ezetimibe group. This might be originated from the statin difference. More large, randomized study will be needed to evaluate this statin difference.
Abstract
Background: Epicardial fat is a visceral thoracic fat and known to be related with presence of dyslipidemia and coronary arterial stenosis. We evaluated the effects and differences of statins on epicardial fat thickness (EFT) in patients underwent successful percutaneous coronary intervention (PCI). Methods: In this retrospective cohort study, we enrolled consecutive patients underwent successful PCI and scheduled six to eight-months follow-up coronary angiography from March 2007 to June 2009. EFT was measured by echocardiography twice at the time of PCI and the follow-up coronary angiography. We included 145 patients (58 females; mean, 63.5 ± 9.5 years). Results: Of the 145 patients, 82 received 20 mg of atorvastatin (atorvastatin group) and 63 medicated with 10 mg of simvastatin with 10 mg of ezetimibe (simvastatin/ezetimibe group). With statin treatments, total cholesterol concentration (189.1 ± 36.1 to 143.3 ± 36.5 mg/dL, p < 0.001), triglycerides (143.5 ± 65.5 to 124.9 ± 63.1 mg/dL, p = 0.005), low density lipoprotein-cholesterol (117.4 ± 32.5 to 76.8 ± 30.9 mg/dL, p < 0.001) and EFT (4.08 ± 1.37 to 3.76 ± 1.29 mm, p < 0.001)were significantly decreased. Atorvastatin and simvastatin/ezetimibe showed similar improvements in the cholesterol profiles. However, atorvastatin decreased EFT more significantly than simvastatin/ezetimibe (EFT change 0.47 ± 0.65 in the atorvastatin vs. 0.12 ± 0.52 mm in the simvastatin/ezetimibe group; p = 0.001). Conclusion: In this study, the atorvastatin group showed significant reduction in EFT than in the simvastatin/ezetimibe group. This might be originated from the statin difference. More large, randomized study will be needed to evaluate this statin difference.
참고문헌 (27)
- Sacks HS, "Human epicardial adipose tissue: a review", Am Heart J, 153, pp.907~917 (2007)
- Lakka HM, "The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men", JAMA, 288, pp.2709~2716 (2002)
- Eckel RH, "Report of the National Heart, Lung, and Blood Institute-National Institute of Diabetes and Digestive and Kidney Diseases Working Group on the pathophysiology of obesityassociated cardiovascular disease", Circulation, 105, pp.2923~2928 (2002)
- Ahn SG, "Relationship of epicardial adipose tissue by echocardiography to coronary artery disease", Heart, 94, pp.e7~ (2008)
- Iacobellis G, "Echocardiographic epicardial adipose tissue is related to anthropometric and clinical parameters of metabolic syndrome: a new indicator of cardiovascular risk", J Clin Endocrinol Metab, 88, pp.5163~5168 (2003)
- Krysiak R, "Effect of atorvastatin and fenofibric acid on adipokine release from visceral and subcutaneous adipose tissue of patients with mixed dyslipidemia and normolipidemic subjects", Pharmacol Rep, 61, pp.1134~1145 (2009)
- Bland JM, "Statistical methods for assessing agreement between two methods of clinical measurement", Lancet, 1, pp.307~310 (1986)
- Ho E, "Formation of the epicardium studied with the scanning electron microscope", Dev Biol, 66, pp.579~585 (1978)
- Taguchi R, "Pericardial fat accumulation in men as a risk factor for coronary artery disease", Atherosclerosis, 157, pp.203~209 (2001)
- Marchington JM, "Adipose tissue in the mammalian heart and pericardium: structure, foetal development and biochemical properties", Comp Biochem Physiol B, 94, pp.225~232 (1989)
- Marchington JM, "Site-specific properties of pericardial and epicardial adipose tissue: the effects of insulin and high-fat feeding on lipogenesis and the incorporation of fatty acids in vitro", Int J Obes, 14, pp.1013~1022 (1990)
- Iacobellis G, "Epicardial adipose tissue: anatomic, biomolecular and clinical relationships with the heart", Nat Clin Pract Cardiovasc Med, 2, pp.536~543 (2005)
- Iacobellis G, "Different “weight” of cardiac and general adiposity in predicting left ventricle morphology", Obesity, 14, pp.1679~1684 (2006)
- Iacobellis G, "Adiposity of the heart", Ann Intern Med, 145, pp.554~555 (2006)
- Iacobellis G, "Epicardial fat from echocardiography: a new method for visceral adipose tissue prediction", Obes Res, 11, pp.304~310 (2003)
- 박은미, "Echocardiographic Epicardial Fat Thickness on Short Term Prognosis in Patients with Acute Coronary Syndrome", Journal of Cardiovascular Ultrasound, 16(2), pp.42~47 (2008), 한국심초음파학회
- Iacobellis G, "Relation of subepicardial adipose tissue to carotid intimamedia thickness in patients with human immunodeficiency virus", Am J Cardiol, 99, pp.1470~1472 (2007)
- Jeong JW, "Echocardiographic epicardial fat thickness and coronary artery disease", Circ J, 71, pp.536~539 (2007)
- Okauchi Y, "Reduction of visceral fat is associated with decrease in the number of metabolic risk factors in Japanese men", Diabetes Care, 30, pp.2392~2394 (2007)
- Busetto L, "Visceral fat loss evaluated by total body magnetic resonance imaging in obese women operated with laparascopic adjustable silicone gastric banding", Int J Obes Relat Metab Disord, 24, pp.60~69 (2000)
- Iacobellis G, "Epicardial adipose tissue as new cardio-metabolic risk marker and potential therapeutic target in the metabolic syndrome", Curr Pharm Des, 13, pp.2180~2184 (2007)
- Iacobellis G, "Substantial changes in epicardial fat thickness after weight loss in severely obese subjects", Obesity, 16, pp.1693~1697 (2008)
- Steinberg D, "The statins in preventive cardiology", N Engl J Med, 359, pp.1426~1427 (2008)
- Ray KK, "The potential relevance of the multiple lipidindependent (pleiotropic) effects of statins in the management of acute coronary syndromes", J Am Coll Cardiol, 46, pp.1425~1433 (2005)
- Baker AR, "Human epicardial adipose tissue expresses a pathogenic profile of adipocytokines in patients with cardiovascular disease", Cardiovasc Diabetol, 5, pp.1~ (2006)
- Smilde TJ, "Effect of aggressive versus conventional lipid lowering on atherosclerosis progression in familial hypercholesterolaemia (ASAP): a prospective, randomised, double-blind trial", Lancet, 357, pp.577~581 (2001)
- Kastelein JJ, "ENHANCE Investigators. Simvastatin with or without ezetimibe in familial hypercholesterolemia", N Engl J Med, 358, pp.1431~1443 (2008)