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31.10.2016 | Original Article

Impact of combined lipid lowering and blood pressure control on coronary plaque: myocardial ischemia treated by percutaneous coronary intervention and plaque regression by lipid lowering and blood pressure controlling assessed by intravascular ultrasonography (MILLION) study

verfasst von: Masa-aki Kawashiri, Kenji Sakata, Kenshi Hayashi, Tadatsugu Gamou, Honin Kanaya, Kenji Miwa, Kosei Ueda, Toshinori Higashikata, Sumio Mizuno, Ichiro Michishita, Masanobu Namura, Yutaka Nitta, Shoji Katsuda, Kazuyasu Okeie, Hiroaki Hirase, Hayato Tada, Katsuharu Uchiyama, Tetsuo Konno, Hidekazu Ino, Keisuke Nagase, Masakazu Yamagishi, Behalf of the MILLION Study Group

Erschienen in: Heart and Vessels | Ausgabe 5/2017

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Abstract

The aim of the study was to elucidate the aggressive reduction of both low-density lipoprotein cholesterol (LDL-C) and blood pressure (BP) reduced coronary atherosclerotic plaque volume compared with a standard treatment of LDL-C and BP in Japanese patients with coronary artery disease (CAD). This study is a prospective, randomized, and open-labelled with a blind-endpoint evaluation study. A total of 97 patients (81 men, mean age 62.0 ± 9.6) with CAD undergoing intravascular ultrasonography (IVUS)-guided percutaneous coronary intervention (PCI) were randomized, and 68 patients had IVUS examinations at baseline and at 18–24 months follow-up. Patients were randomly assigned to standard or aggressive strategies targeting LDL-C and a BP of 100 mg/dL and 140/90 mmHg vs. 70 mg/dL and 120/70 mmHg, respectively. The primary endpoint was the percent change in coronary plaque volume. Both standard and aggressive strategies succeeded to achieve target levels of LDL-C and BP; 74.9 ± 14.7 vs. 63.7 ± 11.9 mg/dL (NS) and 124.1 ± 9.4/75.8 ± 7.7 vs. 113.6 ± 9.6/65.8 ± 9.4 mmHg (systolic BP; NS, diastolic BP; p < 0.05), respectively. Both groups showed a significant reduction in the coronary plaque volume of −9.4 ± 10.7% and −8.7 ± 8.6% (NS) in standard and aggressive therapies, respectively. Both standard and aggressive intervention significantly regressed coronary plaque volume by the same degree, suggesting the importance of simultaneous reductions of LDL-C and BP for prevention of CAD.

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Titel: Impact of combined lipid lowering and blood pressure control on coronary plaque: myocardial ischemia treated by percutaneous coronary intervention and plaque regression by lipid lowering and blood pressure controlling assessed by intravascular ultrasonography (MILLION) study
verfasst von: Masa-aki Kawashiri
Kenji Sakata
Kenshi Hayashi
Tadatsugu Gamou
Honin Kanaya
Kenji Miwa
Kosei Ueda
Toshinori Higashikata
Sumio Mizuno
Ichiro Michishita
Masanobu Namura
Yutaka Nitta
Shoji Katsuda
Kazuyasu Okeie
Hiroaki Hirase
Hayato Tada
Katsuharu Uchiyama
Tetsuo Konno
Hidekazu Ino
Keisuke Nagase
Masakazu Yamagishi
Behalf of the MILLION Study Group
Publikationsdatum: 31.10.2016
Verlag: Springer Japan
Erschienen in: Heart and Vessels / Ausgabe 5/2017
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI: https://doi.org/10.1007/s00380-016-0910-2

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Impact of combined lipid lowering and blood pressure control on coronary plaque: myocardial ischemia treated by percutaneous coronary intervention and plaque regression by lipid lowering and blood pressure controlling assessed by intravascular ultrasonography (MILLION) study

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