A case of borderline diabetic patient identified a quantitative regression and qualitative stability of isolated plaque by coronary CT angiography during purified eicosapentaenoic acid (EPA) administration

Yasushi Koyama, Katsuomi Iwakura, Hiroshi Itoh, Youji Tokunaga, Makoto Horie, Yutaka Otsuki, Atsunori Okamura, Kouich Inoue, Kenshi Fujii

Research output: Contribution to journalArticle

Abstract

Background : A 51-year-old man presented with chest oppression at rest. He had been diagnosed as having borderline diabetes and hypertriglyceridemia. Investigations : Blood test, Double master stress ECG (stress ECG), transthoracic echocardiography (TTE), abdominal scan and coronary CT angiography (CTA) were performed according to his family doctor's proposal and his agreement. Diagnosis : The patient was diagnosed as having a metabolic syndrome without ischemia and coronary artery calcification but mild stenosis with "Positive remodeling" associated with an isolated large plaque burden in between first and second diagonal branches of left anterior descending coronary artery by CTA. Management : He was treated with ultra purified eicosapentaenoic acid (EPA : 1200 mg/ day), aspirin (100mg/day) and diet. At the 12-month follow-up appointment, hypertriglyceridemia and visceral fat were normalized, despite of the failure of diet. On coronary CT image, the new calcified and non calcified plaque was not identified on three major coronary arteries and their branches. The isolated plaque volume between two diagonal branches had 50% reduction (136 mm3) from the baseline (272 mm 3) and also the remodeling index (culprit vessel area ratio based on reference) was improved (1.8 to 1.2). The plaque was seemed to be stabilized or stabilizing according to the increased mean CT attenuation (46 to 52). Conclusions : Twelve months of follow-up has demonstrated that a patient was successfully treated with EPA tailored to reduce the plaque volume quantitatively and also to stabilize it qualitatively, although the large investigation was still needed.

Original languageEnglish
Pages (from-to)219-225
Number of pages7
JournalTherapeutic Research
Volume31
Issue number2
Publication statusPublished - 2010

Fingerprint

Eicosapentaenoic Acid
Coronary Angiography
Coronary Vessels
Hypertriglyceridemia
Electrocardiography
Diet
Intra-Abdominal Fat
Hematologic Tests
Aspirin
Echocardiography
Appointments and Schedules
Pathologic Constriction
Thorax
Ischemia
Computed Tomography Angiography

Keywords

  • EPA

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A case of borderline diabetic patient identified a quantitative regression and qualitative stability of isolated plaque by coronary CT angiography during purified eicosapentaenoic acid (EPA) administration. / Koyama, Yasushi; Iwakura, Katsuomi; Itoh, Hiroshi; Tokunaga, Youji; Horie, Makoto; Otsuki, Yutaka; Okamura, Atsunori; Inoue, Kouich; Fujii, Kenshi.

In: Therapeutic Research, Vol. 31, No. 2, 2010, p. 219-225.

Research output: Contribution to journalArticle

Koyama, Yasushi ; Iwakura, Katsuomi ; Itoh, Hiroshi ; Tokunaga, Youji ; Horie, Makoto ; Otsuki, Yutaka ; Okamura, Atsunori ; Inoue, Kouich ; Fujii, Kenshi. / A case of borderline diabetic patient identified a quantitative regression and qualitative stability of isolated plaque by coronary CT angiography during purified eicosapentaenoic acid (EPA) administration. In: Therapeutic Research. 2010 ; Vol. 31, No. 2. pp. 219-225.
@article{428004f7565e45ff86d172a5719bdfff,
title = "A case of borderline diabetic patient identified a quantitative regression and qualitative stability of isolated plaque by coronary CT angiography during purified eicosapentaenoic acid (EPA) administration",
abstract = "Background : A 51-year-old man presented with chest oppression at rest. He had been diagnosed as having borderline diabetes and hypertriglyceridemia. Investigations : Blood test, Double master stress ECG (stress ECG), transthoracic echocardiography (TTE), abdominal scan and coronary CT angiography (CTA) were performed according to his family doctor's proposal and his agreement. Diagnosis : The patient was diagnosed as having a metabolic syndrome without ischemia and coronary artery calcification but mild stenosis with {"}Positive remodeling{"} associated with an isolated large plaque burden in between first and second diagonal branches of left anterior descending coronary artery by CTA. Management : He was treated with ultra purified eicosapentaenoic acid (EPA : 1200 mg/ day), aspirin (100mg/day) and diet. At the 12-month follow-up appointment, hypertriglyceridemia and visceral fat were normalized, despite of the failure of diet. On coronary CT image, the new calcified and non calcified plaque was not identified on three major coronary arteries and their branches. The isolated plaque volume between two diagonal branches had 50{\%} reduction (136 mm3) from the baseline (272 mm 3) and also the remodeling index (culprit vessel area ratio based on reference) was improved (1.8 to 1.2). The plaque was seemed to be stabilized or stabilizing according to the increased mean CT attenuation (46 to 52). Conclusions : Twelve months of follow-up has demonstrated that a patient was successfully treated with EPA tailored to reduce the plaque volume quantitatively and also to stabilize it qualitatively, although the large investigation was still needed.",
keywords = "EPA",
author = "Yasushi Koyama and Katsuomi Iwakura and Hiroshi Itoh and Youji Tokunaga and Makoto Horie and Yutaka Otsuki and Atsunori Okamura and Kouich Inoue and Kenshi Fujii",
year = "2010",
language = "English",
volume = "31",
pages = "219--225",
journal = "Therapeutic Research",
issn = "0289-8020",
publisher = "Life Science Publishing Co. Ltd",
number = "2",

}

TY - JOUR

T1 - A case of borderline diabetic patient identified a quantitative regression and qualitative stability of isolated plaque by coronary CT angiography during purified eicosapentaenoic acid (EPA) administration

AU - Koyama, Yasushi

AU - Iwakura, Katsuomi

AU - Itoh, Hiroshi

AU - Tokunaga, Youji

AU - Horie, Makoto

AU - Otsuki, Yutaka

AU - Okamura, Atsunori

AU - Inoue, Kouich

AU - Fujii, Kenshi

PY - 2010

Y1 - 2010

N2 - Background : A 51-year-old man presented with chest oppression at rest. He had been diagnosed as having borderline diabetes and hypertriglyceridemia. Investigations : Blood test, Double master stress ECG (stress ECG), transthoracic echocardiography (TTE), abdominal scan and coronary CT angiography (CTA) were performed according to his family doctor's proposal and his agreement. Diagnosis : The patient was diagnosed as having a metabolic syndrome without ischemia and coronary artery calcification but mild stenosis with "Positive remodeling" associated with an isolated large plaque burden in between first and second diagonal branches of left anterior descending coronary artery by CTA. Management : He was treated with ultra purified eicosapentaenoic acid (EPA : 1200 mg/ day), aspirin (100mg/day) and diet. At the 12-month follow-up appointment, hypertriglyceridemia and visceral fat were normalized, despite of the failure of diet. On coronary CT image, the new calcified and non calcified plaque was not identified on three major coronary arteries and their branches. The isolated plaque volume between two diagonal branches had 50% reduction (136 mm3) from the baseline (272 mm 3) and also the remodeling index (culprit vessel area ratio based on reference) was improved (1.8 to 1.2). The plaque was seemed to be stabilized or stabilizing according to the increased mean CT attenuation (46 to 52). Conclusions : Twelve months of follow-up has demonstrated that a patient was successfully treated with EPA tailored to reduce the plaque volume quantitatively and also to stabilize it qualitatively, although the large investigation was still needed.

AB - Background : A 51-year-old man presented with chest oppression at rest. He had been diagnosed as having borderline diabetes and hypertriglyceridemia. Investigations : Blood test, Double master stress ECG (stress ECG), transthoracic echocardiography (TTE), abdominal scan and coronary CT angiography (CTA) were performed according to his family doctor's proposal and his agreement. Diagnosis : The patient was diagnosed as having a metabolic syndrome without ischemia and coronary artery calcification but mild stenosis with "Positive remodeling" associated with an isolated large plaque burden in between first and second diagonal branches of left anterior descending coronary artery by CTA. Management : He was treated with ultra purified eicosapentaenoic acid (EPA : 1200 mg/ day), aspirin (100mg/day) and diet. At the 12-month follow-up appointment, hypertriglyceridemia and visceral fat were normalized, despite of the failure of diet. On coronary CT image, the new calcified and non calcified plaque was not identified on three major coronary arteries and their branches. The isolated plaque volume between two diagonal branches had 50% reduction (136 mm3) from the baseline (272 mm 3) and also the remodeling index (culprit vessel area ratio based on reference) was improved (1.8 to 1.2). The plaque was seemed to be stabilized or stabilizing according to the increased mean CT attenuation (46 to 52). Conclusions : Twelve months of follow-up has demonstrated that a patient was successfully treated with EPA tailored to reduce the plaque volume quantitatively and also to stabilize it qualitatively, although the large investigation was still needed.

KW - EPA

UR - http://www.scopus.com/inward/record.url?scp=77949786250&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77949786250&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:77949786250

VL - 31

SP - 219

EP - 225

JO - Therapeutic Research

JF - Therapeutic Research

SN - 0289-8020

IS - 2

ER -