NEW YORK (Reuters Health) – Pitavastatin is equivalent to atorvastatin in its ability to reduce coronary plaque volume in patients with acute coronary syndrome (ACS), Japanese researchers have found.

The JAPAN-ACE Investigators, led by Dr. Takafumi Hiro of the Yamaguchi University School of Medicine in Ube, conducted a multicenter study in which 307 patients undergoing percutaneous coronary intervention (PCI) were randomized to receive either 4 mg/day of pitavastatin or 20 mg/day of atorvastatin and then followed for 8 to 12 months. Both the baseline PCI and an examination performed at the end of follow-up were guided by intravascular ultrasound, [[abs]] according to the report in the July 21 issue of the Journal of the American College of Cardiology.

In the 252 patients with evaluable ultrasound exams at both time points (representing 82% of patients in each group), [[abs and p295 col 2 bottom]] the authors observed mean reductions in nonculprit plaque volume of 16.9% with pitavastatin and 18.1% with atorvastatin. These reductions were “associated with negative vessel remodeling,” they comment. [[abs]]

“Regression in plaque volume was observed in a broad spectrum of patients regardless of the baseline low-density-lipoprotein-C level,” the researchers said. [[300 col 2]]

These results, they note, support the hypothesis that statins given after the onset of ACS can still reverse atherosclerosis. [[297 col 2 para 4]]

Furthermore, they point out, only the effect of atorvastatin on plaque volume had previously been tested in patients with ACS, and that only in a single-center study. [[abs]] Now, the research team concludes, their finding that pitavastatin and atorvastin “provided a comparable benefit” in a large-scale trial has “generalized the effect of statins… on plaque volume in the setting of ACS.” [[297 col 2 para 4]]

Reference:
J Am Coll Cardiol 2009;54:293-302.