Coronary Artery Occlusive Disease
Conditions
Keywords
Statin, CIMT, BES
Brief summary
Current consensus papers recommend statin medication to reduce Low density lipoprotein (LDL) cholesterol level less than 100mg/dL (optional 70mg/dL) in patients with coronary artery disease. However, there is lack of solid evidence whether a specific kind of statin have the superiority against other statins in clinical outcomes. Furthermore, recent data have showed that several kinds of statin could have an adverse effect on glucose metabolism and increase the risk of development of diabetes. Carotid Intimamedia thickness (CIMT) is a surrogate marker of atherosclerosis to predict long term cardiovascular outcomes in not only general population but also patients with established coronary artery disease. Consequently, we will evaluate the efficacy of high dose of pravastatin on CIMT, comparing with moderate dose of rosuvastatin in patients with established coronary artery disease. Additionally, we will assess the clinical outcomes of pravastatin after percutaneous coronary intervention as well as adverse outcomes including insulin resistance and new onset diabetes compared with rosuvastatin. Our main hypothesis is that pravastatin 40mg would be non-inferior to rosuvastatin 20mg regarding CIMT at 1 year follow up.
Interventions
Pravastatin 40mg PO daily for 1year from the day of BES implantation
Rosuvastatin 20mg PO daily for 1year from the day of BES implantation
Sponsors
Study design
Eligibility
Inclusion criteria
* Patients ≥ 20 years old * Patients with coronary artery disease who are candidate for coronary revascularization with DES implantation. * Significant coronary de novo lesion (stenosis \> 70% by quantitative angiographic analysis) * Patients eligible for statin treatment (initial LDL cholesterol \>70mg/dL or patients taking lipid-lowering agent)
Exclusion criteria
* Severe hepatic dysfunction (3 times normal reference values) * Pregnant women or women with potential childbearing * Life expectancy \< 1 year
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Change of carotid intima media thickness 1 year after pravastatin or rosuvastatin treatment | 1 year after drug-eluting stent implantation |
Countries
South Korea