High baseline levels of advanced glycation end products were significantly associated with coronary plaque progression (OR 1.21) in patients with acute coronary syndrome, independent of diabetes mellitus.
Cohort (n=208)
Open-label, blind endpoint evaluation
Randomized
Yes
Does baseline advanced glycation end products (AGEs) level predict coronary plaque progression in patients with acute coronary syndrome receiving statin therapy?
High baseline levels of advanced glycation end products (AGEs) independently predict coronary plaque progression in ACS patients on statin therapy, suggesting a role for cumulative oxidative stress in atherosclerosis.
Effect estimate: OR 1.21 (95% CI 1.01-1.48)
p-value: p=0.044
Background: The Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome (JAPAN-ACS) trial demonstrated that early aggressive statin therapy in patients with ACS significantly reduces plaque volume (PV). Advanced glycation end products (AGEs) and the receptors of AGEs (RAGE) may lead to angiopathy in diabetes mellitus (DM) and may affect on the development of coronary PV. The present sub-study of JAPAN-ACS investigates the association between AGEs and RAGE, and PV.Methods: Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) was undertaken, followed by the initiation of statin treatment (either 4 mg/day of pitavastatin or 20 mg/day of atorvastatin), in patients with ACS. In the 208 JAPAN-ACS subjects, PV using IVUS in non-culprit segment > 5 mm proximal or distal to the culprit lesion and, serum levels of AGEs and soluble RAGE (sRAGE) were measured at baseline and 8-12 months after PCI.Results: At baseline, no differences in the levels of either AGEs or sRAGE were found between patients with DM and those without DM. The levels of AGEs decreased significantly with statin therapy from 8.6 ± 2.2 to 8.0 ± 2.1 U/ml (p < 0.001), whereas the levels of sRAGE did not change. There were no significant correlations between changes in PV and the changes in levels of AGEs as well as sRAGE. However, high baseline AGEs levels were significantly associated with plaque progression (odds ratio, 1.21; 95% confidence interval, 1.01 - 1.48; p = 0.044) even after adjusting for DM in multivariate logistic regression models.Conclusions: High baseline AGEs levels were associated with plaque progression in the JAPAN-ACS trial. This relationship was independent of DM. These findings suggest AGEs may be related to long-term glucose control and other oxidative stresses in ACS.Trial registration: NCT00242944. © 2013 Fukushima et al.; licensee BioMed Central Ltd.
山岸 et al. (2013) conducted a cohort in Acute Coronary Syndrome (n=208). Pitavastatin vs. Atorvastatin 20 mg/day was evaluated on Plaque progression (percent change in plaque volume ≥0%) (OR 1.21, 95% CI 1.01-1.48, p=0.044). High baseline levels of advanced glycation end products were significantly associated with coronary plaque progression (OR 1.21) in patients with acute coronary syndrome, independent of diabetes mellitus.