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In the post-operative acute stage, carperitide showed cardiorenal protective effects that prevented post-operative cardiac events and initiation of dialysis. Thus, perioperative infusion of low-dose carperitide may have a significant role in management of patients with renal dysfunction undergoing on-pump CABG. (Effectiveness of hANP for Cardiac Surgery in Patients With Moderate to Severe Preoperative Renal Dysfunction Without Dialysis [NU-HIT for CRF]; UMIN000001462).

Circ J 2009; 73: 718 -725 here have been many reports that intensive lowering of low-density lipoprotein-cholesterol (LDL-C) with 3-hydroxy-3-methylglutaryl-coenzyme A (HMGCoA) reductase inhibitors (statins) is effective in preventing cardiovascular events. [1][2][3] Although the mechanism by which statins confer cardiovascular benefit is not precisely understood, regression of coronary plaque volume and reduction of plaque vulnerability are presumed to play important roles. Angioscopic observations have shown that the presence of yellow plaque is associated with unstable symptoms, which suggests that as plaques become more yellow in appearance, they also become more prone to rupture. [4][5][6] Editorial p 628Angioscopy is used to assess plaque vulnerability on the basis of its color and the presence of thrombi. 7,8 Angioscopy gives a full-color, 3-dimensional perspective of the intracoronary surface morphology, and reasonably accurate information regarding a specific lesion, if performed by trained technicians. Intravascular ultrasound (IVUS) is an alternative imaging modality that provides real-time tomographic images of blood vessels on a monitor. It generates information on vessel wall structure, atheroma volume, and the echogenicity of plaque, which is amenable to qualitative and quantitative analysis and can be used to evaluate plaque regression. 9 The effects of statins on coronary plaque have been evaluated by angioscopy, as well as IVUS, in patients with hypercholesterolemia. Using angioscopy, Takano et al demonstrated that the grade of yellow color decreased during statin therapy, 10 and Nissen et al 11 and Okazaki et al 12 used IVUS to investigate the effects of statins on atheroma volume. However, because no study has serially monitored the coronary plaques of patients receiving statin therapy using both angioscopy and IVUS, the relationship between changes in plaque color and changes in atheroma volume has not been elucidated. Therefore, we used both imaging modalities concurrently to investigate the qualitative and quantitative changes over time in coronary plaques in patients receiving atorvastatin therapy to reduce LDL-C levels to ≤100 mg/dl. Methods Study PopulationPatients with coronary artery disease (CAD) complicated by hypercholesterolemia, with a fasting LDL-C level (Received August 10, 2008; accepted December 2, 2008; released online February 18, 2009

One-year lipid-lowering therapy by fluvastatin showed significant regression of plaque volume and alterations in atherosclerotic plaque composition with a significant reduction of fibro-fatty volume.