Pitavastatin More Beneficial than EPA in Decreasing Plaque Vulnerability

SAN FRANCISCO, CA—Pitavastatin has beneficial effects on a marker of oxidative stress and pericellular MT1-MMP activity in hypercholesterolemic patients compared with eicosapentaenoic acid (EPA), according to a study at ACC.13, the American College of Cardiology's 62nd Annual Scientific Session.

Lectin-like oxidized LDL receptor 1 (LOX-1) system activation is involved in atherogenesis, however, molecular mechanisms of this system during plaque vulnerability remain elusive. Membrane-type matrix metalloproteinase (MT-MMPs), the main activators of secretded latent type MMPs, were found to be highly expressed on circulating peripheral blood mononuclear cells from patients with acute myocardial infarction. They were also found to play an important role in plaque vulnerability.

Hiroyasu Uzui, Professor of the Department of Cardiovascular Medicine, from the University of Fukui, Fukui, Japan, and colleagues aimed to investigate the changes in the LOX-1 system and MT1-MMP expression in patients with hypercholesterolemia after the treatment of either pitavastatin or EPA.

A total of 51 patients who had not received anti-dyslipidemic agents and had LDL-C >140 were assigned to two groups: Pitavastatin 2mg once daily (Group P, n=27) and EPA 1,800mg daily (Group E, n=24). LOX-1 ligand, a soluble form of LOX-1 (sLOX-1) and MT1-MMP expression was measured before and at 6 months after treatment.

Study results showed that LDL-C (162 + 29 vs. 103 + 29mg/dL: P<0.01), LOX-1 ligand (8.7 + 3.3 vs. 5.51 + 2.13ng/mL; P<0.01), and MT1-MMP expression (33.6 + 3.1 vs. 30.3 + 6.1%; P<0.05) were significantly reduced in Group P, but there were no significant changes in high-density lipoprotein cholesterol (HDL-C) and sLOX-1.

In Group E, there were no significant changes in LDL-C, LOX-1 ligand, MT!1-MMP expression, HDL-C and sLOX-1, except the ration of EPA to arachidonic acid (EPA/AA) (0.44 + 0.21 vs. 1.19 + 0.64; P <0.01).

“Pitavastatin is useful in decreasing the plaque vulnerability in hypercholesterolemic patients,” concluded Dr. Uzui.  The team was able to conclude that pitavastatin therapy proved more beneficial than EPA in oxidative stress and pericellular MT1-MMP activity in patients with hypercholesterolemia.