Relationship between Target Lesion Revascularization after PCI and Serum Cholesterol levels, and Influence of HMG-CoA Reductase Inhibitors in This Respect

• Published in: Iryo Yakugaku (Japanese Journal of Pharmaceutical Health Care and Sciences) Vol. 31; no. 10; pp. 808 - 814
• Main Authors: Takeuchi, Masako, Yazaki, Tomoko, Yoshiyama, Yuji, Ui, Susumu, Kanke, Motoko
• Format: Journal Article
• Language: Japanese
• Published: Japanese Society of Pharmaceutical Health Care and Sciences 10.10.2005
• Subjects: HMG-CoA reductase inhibitors; hyperlipidemia; PCI (percutaneous coronary intervention); restenosis; TLR (target lesion revascularization)
• ISSN: 1346-342X; 1882-1499
• DOI: 10.5649/jjphcs.31.808

In patients with ischemic heart disease, it has been reported that the incidence of cardiovascular events and mortality may be reduced by improving serum cholesterol levels. In the present study, we looked for a correlation between high cholesterol levels and restenosis, which usually occurs within six months of percutaneous coronary intervention (PCI), since this had not been examined previously. We retrospectively investigated 656 serial patients who underwent PCI during the period 1998 through 2001. Patients whose restenosis was treated by target lesion revascularization (TLR) had higher serum cholesterol levels and the incidence of hyperlipidemia, a risk factor of coronary heart disease, and frequency of TLR were higher in 2001 than in other years. Two-hundred-thirty-one patients who underwent PCI in this year were investigated in the first month after PCI and 6 months afterwards to see whether lowering serum lipid levels affected the frequency of TLR. Patients with high total cholesterol (TC) and low density lipoprotein cholesterol (LDLC) levels prior to PCI had a higher incidence of restenosis and lowering lipid serum levels after PCI did not prevent the restenosis. In patients whose TC and LDLC levels had been controlled prior to PCI through medication, the incidence of restenosis was comparable to patients having ischemic heart disease without hypercholesterolemia. Those who were treated with pravastatin (N=54), simvastatin (N=24), or atorvastatin (N=63) showed no significant difference in the efficacy of lowering TC and LDLC levels among the three groups.