Analysis of plaque reduction and stabilization effects by active lipid-lowering therapy for peripheral artery diseases

2021 Fiscal Year Final Research Report

• Project/Area Number: 20K17090
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 53020:Cardiology-related
• Research Institution: Kyoto Prefectural University of Medicine
• Principal Investigator: Yanishi Kenji 京都府立医科大学, 医学(系)研究科(研究院), 助教 (10793341)
• Project Period (FY): 2020-04-01 – 2022-03-31
• Keywords: 末梢動脈疾患 / 積極的脂質低下療法 / 血管内プラーク / 経皮的下肢血管形成術 / 近赤外線分光法 / LDLコレステロール

Outline of Final Research Achievements

The purpose of this study was to evaluate the effect of aggressive lipid-lowering therapy (drug intensification with a target LDL cholesterol level of <70 mg/dl) on plaque regression and stabilization in lower extremity vessels in patients with peripheral arterial disease (PAD).First, we evaluated whether aggressive lipid-lowering therapy could be safely administered to patients with PAD who had undergone percutaneous lower extremity angioplasty in a preliminary study of 10 patients with PAD.
Because this preliminary study was delayed by the coronavirus pandemic that severely limited our usual practice, this preliminary study took 2 years to enroll the 10 patients.
Base on this preliminary study, there were no adverse events (death, cardiovascular events, lower extremity amputations, etc.) that occurred after aggressive lipid-lowering therapy and no safety issues.

Free Research Field

末梢動脈疾患

Academic Significance and Societal Importance of the Research Achievements

末梢動脈疾患は今後高齢化と共に増加してくることが予想され、悪化すれば肢切断に至る予後が悪い疾患である。高LDLコレステロール血症は、心血管病において重要な危険因子の一つである。積極的脂質低下療法(LDLコレステロールを70未満に低下させること)は、冠動脈疾患患者において、血管内プラーク（脂質）を退縮させ、心血管イベント抑制（心筋梗塞・狭心症、脳梗塞の発症率低下）に繋がることが報告されている。しかし、末梢動脈疾患に与える臨床的影響は明らかでなかった。積極的脂質低下療法は、末梢動脈疾患患者の動脈硬化進展予防に繋がり、経皮的下肢血管形成術後の再狭窄・再血行再建術を減らすことに十分期待できうる。