J Cardiovasc Ultrasound.  2010 Dec;18(4):121-126. 10.4250/jcu.2010.18.4.121.

Effects of Statins on the Epicardial Fat Thickness in Patients with Coronary Artery Stenosis Underwent Percutaneous Coronary Intervention: Comparison of Atorvastatin with Simvastatin/Ezetimibe

• Park JH
• Park YS
• Kim YJ
• Lee IS
• Kim JH
• Lee JH
• Choi SW
• Jeong JO
• Seong IW

• KMID: 2177312
• DOI: http://doi.org/10.4250/jcu.2010.18.4.121

Abstract

BACKGROUND
Epicardial fat is a visceral thoracic fat and known to be related with presence of dyslipidemia and coronary arterial stenosis. We evaluated the effects and differences of statins on epicardial fat thickness (EFT) in patients underwent successful percutaneous coronary intervention (PCI).
METHODS
In this retrospective cohort study, we enrolled consecutive patients underwent successful PCI and scheduled six to eight-months follow-up coronary angiography from March 2007 to June 2009. EFT was measured by echocardiography twice at the time of PCI and the follow-up coronary angiography. We included 145 patients (58 females; mean, 63.5 +/- 9.5 years).
RESULTS
Of the 145 patients, 82 received 20 mg of atorvastatin (atorvastatin group) and 63 medicated with 10 mg of simvastatin with 10 mg of ezetimibe (simvastatin/ezetimibe group). With statin treatments, total cholesterol concentration (189.1 +/- 36.1 to 143.3 +/- 36.5 mg/dL, p < 0.001), triglycerides (143.5 +/- 65.5 to 124.9 +/- 63.1 mg/dL, p = 0.005), low density lipoprotein-cholesterol (117.4 +/- 32.5 to 76.8 +/- 30.9 mg/dL, p < 0.001) and EFT (4.08 +/- 1.37 to 3.76 +/- 1.29 mm, p < 0.001) were significantly decreased. Atorvastatin and simvastatin/ezetimibe showed similar improvements in the cholesterol profiles. However, atorvastatin decreased EFT more significantly than simvastatin/ezetimibe (EFT change 0.47 +/- 0.65 in the atorvastatin vs. 0.12 +/- 0.52 mm in the simvastatin/ezetimibe group; p = 0.001).
CONCLUSION
In this study, the atorvastatin group showed significant reduction in EFT than in the simvastatin/ezetimibe group. This might be originated from the statin difference. More large, randomized study will be needed to evaluate this statin difference.

Keyword

Percutaneous coronary intervention; Epicardial fat; Statins

MeSH Terms

Azetidines
Cholesterol
Cohort Studies
Constriction, Pathologic
Coronary Angiography
Coronary Stenosis
Coronary Vessels
Dyslipidemias
Echocardiography
Follow-Up Studies
Heptanoic Acids
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Percutaneous Coronary Intervention
Pyrroles
Retrospective Studies
Simvastatin
Triglycerides
Atorvastatin Calcium
Ezetimibe
Azetidines
Cholesterol
Heptanoic Acids
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Pyrroles
Simvastatin
Triglycerides

Figure

• 

  Fig. 1 Echocardiographic measurement of EFT with parasternal long-axis view. Anterior echo-lucent space between the linear echo-dense parietal pericardium and the epicardium was considered to be epicardial adipose tissue (arrows). Mediastinal fat, seen as an echo-lucent area located above the parietal pericardium, was not included in the measurement. EFT was decreased from 6.0 mm at the time of percutaneous coronary intervention (A) to 5.2 mm at the time of follow-up angiography after 6 months (B). PCI: percutaneous coronary intervention, EFT: epicardial fat thickness.

• 

  Fig. 2 Change of epicardial fat thickness (EFT) according to the statin (A: atorvastatin, B: simvastatin/ezetimibe). Atorvastatin was associated with significant reduction of EFT.

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