Pitavastatin could help prevent ischaemic complications with carotid artery stenting, EPOCH-CAS data shows


Data presented at CIRSE (14–18 September, Barcelona, Spain) by a team of investigators from Japan showed that pre-treatment with pitavastatin significantly reduced the frequency of periprocedural ischaemic complications associated with carotid artery stenting.

Katsutoshi Takayama, from the Department of Radiology and Interventional Neuroradiology, Ishinkai Yao General Hospital, Yao city, Japan, reported on the Effect of Pitavastatin on preventing ischaemic complications with carotid artery stenting (EPOCH-CAS) and told delegates that it was a multicentre prospective study carried out at 11 centres in Japan.

Takayama said: “Carotid artery stenting is becoming an alternative to carotid endarterectomy. However, periprocedural ischemic stroke is one problem associated with stenting. Statin therapy can reportedly reduce periprocedural complication rates in coronary intervention. We aimed to assess whether preoperative statin therapy reduces the risk of periprocedural ischaemic complications with carotid artery stenting.”

The researchers divided patients with carotid stenosis (symptomatic ≥50%, asymptomatic ≥80%) and at high risk of requiring endarterectomy, but without previous statin treatment, into two groups by low-density lipoprotein cholesterol level.

Patients with low-density lipoproteins ≥120 mg/dl were put in group I, received 4mg/day pitavastatin for four weeks. In the second group, which included patients who had low-density lipoproteins
Frequencies of new ipsilateral ischaemic lesions on diffusion-weighted imaging (DWI) within 72h after carotid artery stenosis and major adverse events (defined as transient ischaemic attack, stroke, myocardial infarction or death) within 30 days were assessed.

Takayama et al found that among the 80 patients enrolled, 61 (group I, n=31; group II, n=30) fulfilled the inclusion criteria. New ipsilateral ischaemic lesions were identified in eight of 31 patients (25.8%) in group 1 and 16 of 30 patients (55.3%) in group II (p=0.027). Major adverse events occurred in 0 patients in group 1 and in three of 30 patients (10%) in group II (p= 0.07).