Abstract
Background: We investigated the combined effects of physical activity (PA) and aggressive low-density lipoprotein cholesterol (LDL-C) reduction on the changes in coronary plaque volume (PV) in patients with acute coronary syndrome (ACS) using volumetric intravascular ultrasound (IVUS) analysis. Methods: We retrospectively analyzed data from two different prospective clinical trials that involved 101 ACS patients who underwent percutaneous coronary intervention (PCI) and assessed the non-culprit sites of PCI lesions using IVUS at baseline and at the follow-up. After PCI, all the patients participated in early phase II comprehensive cardiac rehabilitation. Patients were divided into four groups based on whether the average daily step count, measured using a pedometer, was 7000 steps of more and whether the follow-up LDL-C level was <70 mg/dL. At the time of follow-up, we examined the correlation of changes in the PV with LDL-C and PA. Results: The baseline characteristics of the four study groups were comparable. At the follow-up, plaque regression in both the achievement group (PA and LDL-C reduction) was higher than that in the other three groups. In addition, plaque reduction independently correlated with increased PA and reduction in LDL-C level. Conclusions: Combined therapy of intensive PA and achievement of LDL-C target retarded coronary PV in patients with ACS.
Highlights
The prognosis of acute coronary syndrome (ACS) patients is poor; the management of low-density lipoprotein cholesterol (LDL-C) levels improves the prognosis
We demonstrated that intensive physical activity (PA) retarded coronary plaque volume (PV) progression and ameliorated lipid component in patients with ACS participating in late phase II Cardiac rehabilitation (CR) [5]
Study Population and Clinical Characteristics. One of these trials enrolled 50 ACS patients who were admitted to the Juntendo University Hospital and Showa University Hospital from December 2009 to August 2012 [4]
Summary
The prognosis of acute coronary syndrome (ACS) patients is poor; the management of low-density lipoprotein cholesterol (LDL-C) levels improves the prognosis. Plaque regression following the management of blood lipid levels has clinical significance. We recently used serial integrated backscatter intravascular ultrasonography (IVUS) to show that coronary plaque volume (PV) regression in ACS patients significantly and positively correlated to physical activity (PA) [4]. Our study aimed to investigate the combined effects of PA and achievement of LDL-C target on the changes in coronary PV in ACS patients, as assessed using volumetric intravascular ultrasound (IVUS) analysis. We investigated the combined effects of physical activity (PA) and aggressive low-density lipoprotein cholesterol (LDL-C) reduction on the changes in coronary plaque volume (PV) in patients with acute coronary syndrome (ACS) using volumetric intravascular ultrasound (IVUS) analysis.
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