Key result
Achieving both ≥7000 steps/day and LDL-C <70 mg/dL was associated with greater coronary plaque regression compared to not achieving both targets in patients with acute coronary syndrome.
Why the study?
The combined effects of physical activity and aggressive LDL-C reduction on changes in coronary plaque volume in patients with ACS remained to be investigated.
Does achieving both physical activity (≥7000 steps/day) and LDL-C (<70 mg/dL) targets improve coronary plaque regression in patients with ACS after PCI?
Cohort (n=101)
Does achieving both physical activity (≥7000 steps/day) and LDL-C (<70 mg/dL) targets improve coronary plaque regression in patients with ACS after PCI?
Achieving both physical activity targets and aggressive LDL-C reduction promotes greater coronary plaque regression in ACS patients post-PCI.
May support combined step and LDL-C targets for plaque regression post-ACS; hypothesis-generating and requires randomized confirmation.
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.
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Nishitani‐Yokoyama et al. (2020) conducted a cohort in Acute coronary syndrome (n=101). Combined physical activity (≥7000 steps/day) and LDL-C reduction (<70 mg/dL) vs. Not achieving both targets (other three groups) was evaluated on Changes in coronary plaque volume. Achieving both ≥7000 steps/day and LDL-C <70 mg/dL was associated with greater coronary plaque regression compared to not achieving both targets in patients with acute coronary syndrome.
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