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Difference in statin effects on neointimal coverage after implantation of drug-eluting stents

Yamamoto, Hiroyuki; Ikuta, Shinichiro; Kobuke, Kazuhiro; Yasuda, Masakazu; Ikeda, Tomoyuki; Yamaji, Kenji; Ueno, Masafumi; Iwanaga, Yoshitaka; Miyazaki, Shunichi

doi: 10.1097/MCA.0000000000000102
Original Research

Objective This study was carried out to examine the difference in effects between rosuvastatin and pravastatin on neointimal formation after the placement of a drug-eluting stent (DES).

Materials and methods Forty patients who underwent placement of a DES in our hospital were prospectively randomized to receive rosuvastatin (n=20) or pravastatin (n=20), and analyzed by optical coherence tomography at the chronic stage. The main outcome measure was comparison of neointimal coverage analyzed at a strut level.

Results A significant reduction in total cholesterol, low-density lipoprotein, and white blood cell count was observed during the study in the rosuvastatin group (total cholesterol, from 4.82±0.90 to 4.43±0.77 mmol/l, P=0.038; low-density lipoprotein, from 2.85±0.76 to 2.34±0.57 mmol/l, P=0.006; white blood cell count, from 5810±1399 to 5355±1257/µl, P=0.048), but not in the pravastatin group. Although not statistically significant, C-reactive protein was lower in the rosuvastatin than in the pravastatin group at the chronic stage (1.14±1.21 vs. 7.67±13.67 mg/l, P=0.051). Malapposed and uncovered struts were significantly less frequent in the rosuvastatin group than in the pravastatin group (malapposed, 0.06 vs. 0.60%, P<0.001; uncovered, 6.49 vs. 11.29%, P<0.001). The difference in uncovered struts was maintained even when stent types were analyzed separately (everolimus-eluting stent, 4.81 vs. 6.21%, P=0.007; sirolimus-eluting stent, 14.40 vs. 20.86%, P<0.001). Comparison of neointimal thickness between the rosuvastatin and the pravastatin groups showed inconsistent results depending on the stent types analyzed.

Conclusion Compared with pravastatin, the use of rosuvastatin resulted in lower frequency of uncovered and malapposed struts after the placement of a DES, which might be mediated through improved inflammatory and lipid profiles.

Department of Medicine, Division of Cardiology, Faculty of Medicine, Kinki University, Osaka, Japan

Correspondence to Shunichi Miyazaki, MD, PhD, Department of Medicine, Division of Cardiology, Faculty of Medicine, Kinki University, 377-2 Ohnohigashi, Osakasayama, Osaka 589-8511, Japan Tel: +81 72 366 0221; fax: +81 72 368 2378; e-mail:

Received December 19, 2013

Accepted February 3, 2014

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins