Impacts of conventional coronary risk factors, diabetes and hypertension, on coronary atherosclerosis during statin therapy

Abstract

Patients with diabetes mellitus (DM) and hypertension (HT) are at a high risk of coronary artery disease. However, the mechanisms underlying this have not been well characterized. The purpose of the present study was to evaluate the impacts of DM and HT on coronary atherosclerosis during statin therapy. The effects of 8-month statin therapy on coronary atherosclerosis were evaluated in the TRUTH study using virtual histology intravascular ultrasound. Analyzable intravascular ultrasound data were obtained from 119 patients who were divided into four subgroups, namely, group A: DM (+), HT (+); group B: DM (+), HT (-); group C: DM (-), HT (+); and group D: DM (-), HT (-). The pattern of arterial remodeling, extent of coronary atherosclerosis, and plaque composition were compared among the four subgroups. Atheroma volume decreased significantly in group D (-3.9%, P=0.01), whereas it tended to increase in group A (1.0%, P=0.77). A significant difference in the mean percent change of atheroma volume was observed between groups A and D (1.0 vs. -3.9%, P=0.03). Furthermore, the frequency of progression in atheroma volume was significantly higher in group A (60, 33, 45, and 24% in groups A, B, C, and D, respectively; P=0.03). No significant differences in the changes in the four plaque components among the four subgroups were observed. A combination of DM and HT attenuates the degree of regression of coronary atherosclerosis, but does not influence changes in plaque composition during statin therapy.