Japanese Heart Journal
Online ISSN : 1348-673X
Print ISSN : 0021-4868
ISSN-L : 0021-4868
Clinical Studies
Angioscopic Evaluation of Stabilizing Effects of an Antilipemic Agent, Bezafibrate, on Coronary Plaques in Patients with Coronary Artery Disease
A Multicenter Prospective Study
Hidefumi Ohsawa, Yasumi Uchida, Yoshiharu Fujimori, Junichi Hirose, Hirofumi Noike, Keiichi Tokuhiro, Kohei Kawamura, Masahito Kanai, Hiroshi Sakuragawa, Takashi Hitsumoto, Kaneyuki Aoyagi, Takeshi Sakurai, Shin Sato, Kunio Yoshinaga, Michihisa Kaku, Masaaki Ozegawa, Hiroshi Morio, Katsumi Yamada, Kimiko Terasawa, Yuuko Uchida, Tomomitsu Ohshima
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Keywords: Coronary plaque, Bezafibrate, Plaque stabilization, Angioscopy
JOURNAL FREE ACCESS

2002 Volume 43 Issue 4 Pages 319-331

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Abstract

To evaluate the stabilizing effects of an antilipemic agent, bezafibrate, on coronary plaques, we carried out a prospective angioscopic and angiographic open trial. From April 1997 to December 1998, 24 patients underwent coronary angioscopy of plaques in non-targeted vessels during coronary interventions and then again 6 months later. The patients were divided into control (10 patients, 14 plaques) and bezafibrate (14 patients, 21 plaques) groups. Oral administration of bezafibrate (400 mg/day) was started immediately after the intervention and was continued for 6 months. The vulnerability score was determined based on the angioscopic characteristics of plaques and compared before and 6 months later. Six months later, the vulnerability score was reduced (from 1.6 to 0.8; P<0.05) in the bezafibrate group and unchanged (from 1.4 to 1.3; NS) in the control group. In the bezafibrate group, the changes in the vulnerability score were not correlated with those in % stenosis or minimal lumen diameter. The plasma total cholesterol level (T-C) was unchanged, triglyceride level (TG) was decreased, and high density lipoprotein cholesterol level (HDL-C) was increased in the bezafibrate group, but were unchanged in the control group. In the bezafibrate group, T-C and TG were decreased and HDL-C was increased in patients with a reduced vulnerability score but were unchanged in those with an unchanged score. These results indicate that 6 month administration of bezafibrate stabilizes coronary plaques and that the stabilization is not correlated with angiographic changes.

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© 2002 by the Japanese Heart Journal
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