Comparison of Effects of Serum n-3 to n-6 Polyunsaturated Fatty Acid Ratios on Coronary Atherosclerosis in Patients Treated With Pitavastatin or Pravastatin Undergoing Percutaneous Coronary Intervention

doi:10.1016/j.amjcard.2013.01.327

The American Journal of Cardiology

Volume 111, Issue 11, 1 June 2013, Pages 1570-1575

https://doi.org/10.1016/j.amjcard.2013.01.327 Get rights and content

A low n-3 to n-6 polyunsaturated fatty acid (PUFA) ratio is associated with cardiovascular events. However, the effects of this ratio on coronary atherosclerosis have not been fully examined, particularly in patients treated with different types of statins. This study compared the effects of n-3 to n-6 PUFA ratios on coronary atherosclerosis in patients treated with pitavastatin and pravastatin. Coronary atherosclerosis in nonculprit lesions in the percutaneous coronary intervention vessel was evaluated using virtual histology intravascular ultrasound in 101 patients at the time of percutaneous coronary intervention and 8 months after statin therapy. Pitavastatin and pravastatin were used to treat 51 and 50 patients, respectively. Changes in the docosahexaenoic acid (DHA)/arachidonic acid (AA) and eicosapentaenoic acid+DHA/AA ratios were not correlated with the percentage change in plaque volume in the pitavastatin group, whereas the percentage change in plaque volume and the changes in the DHA/AA ratio (r = −0.404, p = 0.004) and eicosapentaenoic acid+DHA/AA ratio (r = −0.350, p = 0.01) in the pravastatin group showed significant negative correlations. Multivariate regression analysis showed that age (β = 0.306, p = 0.02), the presence of diabetes mellitus (β = 0.250, p = 0.048), and changes in the DHA/AA ratio (β = −0.423, p = 0.001) were significant predictors of the percentage change in plaque volume in patients treated with pravastatin. In conclusion, decreases in n-3 to n-6 PUFA ratios are associated with progression in coronary atherosclerosis during pravastatin therapy but not during pitavastatin therapy.

Section snippets

Methods

This study was a post hoc analysis of the Treatment With Statin on Atheroma Regression Evaluated by Intravascular Ultrasound With Virtual Histology (TRUTH) study. The TRUTH study was a prospective, open-labeled, randomized, multicenter trial performed at 11 Japanese centers to compare the effects of 8-month treatment with pitavastatin and pravastatin on coronary atherosclerosis using virtual histology (VH) intravascular ultrasound (IVUS).¹⁰ Briefly, 164 patients with angina pectoris were

Results

The baseline characteristics of the subjects are shown in Table 1. Pitavastatin and pravastatin were used to treat 51 and 50 patients, respectively. None of the baseline characteristics were significantly different between the 2 groups, except for the frequency of calcium channel blocker use. Serum low-density lipoprotein cholesterol levels decreased significantly in both groups (pitavastatin group, −41%, p <0.0001; pravastatin group, −28%, p <0.0001). The mean low-density lipoprotein

Discussion

The major findings of this study are as follows: (1) changes in the n-3 to n-6 PUFA ratios, particularly the DHA/AA and EPA+DHA/AA ratios were negatively correlated with the percentage change in plaque volume in patients treated with pravastatin, whereas these correlations were not observed in patients treated with pitavastatin, (2) changes in the DHA/AA ratio were a significant predictor of percentage changes in plaque volume during pravastatin therapy but not during pitavastatin therapy, and

Disclosures

The authors have no conflicts of interest to disclose.

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Coronary artery diseaseComparison of Effects of Serum n-3 to n-6 Polyunsaturated Fatty Acid Ratios on Coronary Atherosclerosis in Patients Treated With Pitavastatin or Pravastatin Undergoing Percutaneous Coronary Intervention

Section snippets

Methods

Results

Discussion

Disclosures

Lancet

Am J Clin Nutr

J Am Coll Cardiol

J Am Coll Cardiol

Prostaglandins Leukot Essent Fatty Acids

Am J Cardiol

J Am Coll Cardiol

Atherosclerosis

Lancet

Atherosclerosis

Intake of fish and n3 fatty acids and risk of coronary heart disease among Japanese: the Japan Public Health Center-Based (JPHC) Study Cohort I

Circulation

Cardiac benefits of fish consumption may depend on the type of fish meal consumed: the Cardiovascular Health Study

Circulation

Coronary artery disease
Comparison of Effects of Serum n-3 to n-6 Polyunsaturated Fatty Acid Ratios on Coronary Atherosclerosis in Patients Treated With Pitavastatin or Pravastatin Undergoing Percutaneous Coronary Intervention