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

• Published in: The American journal of cardiology 2013-06, Vol.111 (11), p.1570-1575
• Main Authors: Nozue, Tsuyoshi, MD, Yamamoto, Shingo, MD, Tohyama, Shinichi, MD, Fukui, Kazuki, MD, Umezawa, Shigeo, MD, Onishi, Yuko, MD, Kunishima, Tomoyuki, MD, Sato, Akira, MD, Nozato, Toshihiro, MD, Miyake, Shogo, MD, Takeyama, Youichi, MD, Morino, Yoshihiro, MD, Yamauchi, Takao, MD, Muramatsu, Toshiya, MD, Hibi, Kiyoshi, MD, Terashima, Mitsuyasu, MD, Michishita, Ichiro, MD
• Format: Article
• Language: English
• Subjects: Aged; Angina pectoris; Atherosclerosis - blood; Atherosclerosis - diagnostic imaging; Atherosclerosis - therapy; Biomarkers - blood; Cardiovascular; Cardiovascular disease; Cholesterol; Coronary Artery Disease - blood; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - therapy; Dose-Response Relationship, Drug; Fatty Acids, Omega-3 - blood; Fatty Acids, Omega-6 - blood; Female; Follow-Up Studies; Heart attacks; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Male; Percutaneous Coronary Intervention; Pravastatin - administration & dosage; Pravastatin - therapeutic use; Prospective Studies; Quinolines - administration & dosage; Quinolines - therapeutic use; Ratios; Severity of Illness Index; Treatment Outcome; Ultrasonography, Interventional - methods
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2013.01.327

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.