{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:52:13Z","timestamp":1760237533607,"version":"build-2065373602"},"reference-count":26,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2020,5,22]],"date-time":"2020-05-22T00:00:00Z","timestamp":1590105600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"MEXT (Ministry of Education, Culture, Sports, Science and Technology)-Supported Program for the Strategic Research Foundation at Private Universities, Japan and a Grant-in-Aid for Scientific Research from the Japan Society for the Promotion of Science, Ja","award":["C-2159091, 15K09128"],"award-info":[{"award-number":["C-2159091, 15K09128"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: We investigated the combined effects of physical activity (PA) and aggressive low-density lipoprotein cholesterol (LDL-C) reduction on the changes in coronary plaque volume (PV) in patients with acute coronary syndrome (ACS) using volumetric intravascular ultrasound (IVUS) analysis. Methods: We retrospectively analyzed data from two different prospective clinical trials that involved 101 ACS patients who underwent percutaneous coronary intervention (PCI) and assessed the non-culprit sites of PCI lesions using IVUS at baseline and at the follow-up. After PCI, all the patients participated in early phase II comprehensive cardiac rehabilitation. Patients were divided into four groups based on whether the average daily step count, measured using a pedometer, was 7000 steps of more and whether the follow-up LDL-C level was &lt;70 mg\/dL. At the time of follow-up, we examined the correlation of changes in the PV with LDL-C and PA. Results: The baseline characteristics of the four study groups were comparable. At the follow-up, plaque regression in both the achievement group (PA and LDL-C reduction) was higher than that in the other three groups. In addition, plaque reduction independently correlated with increased PA and reduction in LDL-C level. Conclusions: Combined therapy of intensive PA and achievement of LDL-C target retarded coronary PV in patients with ACS.<\/jats:p>","DOI":"10.3390\/jcm9051578","type":"journal-article","created":{"date-parts":[[2020,5,22]],"date-time":"2020-05-22T10:18:18Z","timestamp":1590142698000},"page":"1578","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preliminary Pilot Study of Combined Effects of Physical Activity and Achievement of LDL-Cholesterol Target on Coronary Plaque Volume Changes in Patients with Acute Coronary Syndrome"],"prefix":"10.3390","volume":"9","author":[{"given":"Miho","family":"Nishitani-Yokoyama","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan"},{"name":"Cardiovascular Rehabilitation and Fitness, Juntendo University Hospital, Tokyo 113-8431, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsumi","family":"Miyauchi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3708-7192","authenticated-orcid":false,"given":"Kazunori","family":"Shimada","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan"},{"name":"Cardiovascular Rehabilitation and Fitness, Juntendo University Hospital, Tokyo 113-8431, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0646-4546","authenticated-orcid":false,"given":"Takayuki","family":"Yokoyama","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shohei","family":"Ouchi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatsuro","family":"Aikawa","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitsuhiro","family":"Kunimoto","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miki","family":"Yamada","sequence":"additional","affiliation":[{"name":"Cardiovascular Rehabilitation and Fitness, Juntendo University Hospital, Tokyo 113-8431, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akio","family":"Honzawa","sequence":"additional","affiliation":[{"name":"Cardiovascular Rehabilitation and Fitness, Juntendo University Hospital, Tokyo 113-8431, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shinya","family":"Okazaki","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Tsujita","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, School of Medicine, Showa University, Tokyo 142-8666, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3345-2703","authenticated-orcid":false,"given":"Shinji","family":"Koba","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, School of Medicine, Showa University, Tokyo 142-8666, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Daida","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan"},{"name":"Faculty of Health Science, Juntendo University, Tokyo 113-0033, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,5,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1495","DOI":"10.1056\/NEJMoa040583","article-title":"Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction 22 Investigators. Intensive versus moderate lipid lowering with statins after acute coronary syndromes","volume":"350","author":"Cannon","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.ahj.2008.08.010","article-title":"Lipid levels in patients hospitalized with coronary artery disease: An analysis of 136,905 hospitalizations in Get With The Guidelines","volume":"157","author":"Sachdeva","year":"2009","journal-title":"Am. Heart J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1177\/2047487317704954","article-title":"Planning secondary prevention: Room for improvement","volume":"24","author":"Fitzsimons","year":"2017","journal-title":"Eur. J. Prev. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1536\/ihj.15-049","article-title":"Effects of Phase II Comprehensive Cardiac Rehabilitation on Coronary Plaque Volume After Acute Coronary Syndrome","volume":"56","author":"Miyauchi","year":"2015","journal-title":"Int. Heart J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1253\/circj.CJ-18-0738","article-title":"Impact of physical activity on coronary plaque volume and components in acute coronary syndrome patients after early phase II cardiac rehabilitation","volume":"83","author":"Miyauchi","year":"2018","journal-title":"Circ. J."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"846","DOI":"10.5551\/jat.GL2017","article-title":"Committee for Epidemiology and Clinical Management of Atherosclerosis. Japan Atherosclerosis Society Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2017","volume":"25","author":"Kinoshita","year":"2018","journal-title":"J. Atheroscler. Thromb."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1007\/s00421-012-2421-x","article-title":"Associations between Borg\u2019s rating of perceived exertion and physiological measures of exercise intensity","volume":"113","author":"Scherr","year":"2013","journal-title":"Eur. J. Appl. Physiol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"2935","DOI":"10.1016\/j.jacc.2013.11.005","article-title":"2013 ACC\/AHA guideline on the assessment of cardiovascular risk: A report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"63","author":"Goff","year":"2014","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"804","DOI":"10.1161\/01.CIR.0000025609.13806.31","article-title":"Multiple atherosclerotic plaque rupture in acute coronary syndrome: A three-vessel intravascular ultrasound study","volume":"106","author":"Rioufol","year":"2002","journal-title":"Circulation"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"National Cholesterol Education Program (NCEP), and Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2002). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation, 106, 3143\u20133421.","DOI":"10.1161\/circ.106.25.3143"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1161\/01.CIR.0000142048.94084.CA","article-title":"Relationship between cardiovascular risk as predicted by established risk scores versus plaque progression as measured by serial intravascular ultrasound in left main coronary arteries","volume":"110","author":"Hartmann","year":"2004","journal-title":"Circulation"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"485","DOI":"10.1016\/j.jacc.2014.02.615","article-title":"Very low levels of atherogenic lipoproteins and the risk for cardiovascular events: A meta-analysis of statin trials","volume":"64","author":"Boekholdt","year":"2014","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1161\/01.CIR.0000140261.58966.A4","article-title":"Early statin treatment in patients with acute coronary syndrome: Demonstration of the beneficial effect on atherosclerotic lesions by serial volumetric intravascular ultrasound analysis during half a year after coronary event: The ESTABLISH Study","volume":"110","author":"Okazaki","year":"2004","journal-title":"Circulation"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.jacc.2009.04.033","article-title":"JAPAN-ACS Investigators: Effect of intensive statin therapy on regression of coronary atherosclerosis in patients with acute coronary syndrome: A multicenter randomized trial evaluated by volumetric intravascular ultrasound using pitavastatin versus atorvastatin (JAPAN-ACS [Japan assessment of pitavastatin and atorvastatin in acute coronary syndrome] study)","volume":"54","author":"Hiro","year":"2009","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"592","DOI":"10.5551\/jat.48603","article-title":"The Goal of Achieving Atherosclerotic Plaque Regression with Lipid-Lowering Therapy: Insights from IVUS Trials","volume":"26","author":"Daida","year":"2019","journal-title":"J. Atheroscler. Thromb."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jacc.2015.10.044","article-title":"Exercise-Based Cardiac Rehabilitation for Coronary Heart Disease: Cochrane Systematic Review and Meta-Analysis","volume":"67","author":"Anderson","year":"2016","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_17","first-page":"CD001800","article-title":"Exercise-based cardiac rehabilitation for coronary heart disease","volume":"1","author":"Anderson","year":"2016","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_18","unstructured":"(2000, March 25). Guidelines for Rehabilitation in Patients with Cardiovascular Disease (JCS 2012). Available online: http:\/\/www.j-circ.or.jp\/guideline\/pdf\/JCS2012_nohara_h.pdf."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"954","DOI":"10.1253\/circj.CJ-09-0705","article-title":"Coronary plaque regression and lifestyle modification in patients treated with pravastatin. Assessment mainly by daily aerobic exercise and an increase in the serum level of high-density lipoprotein cholesterol","volume":"74","author":"Tani","year":"2010","journal-title":"Circ. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1053\/hj.1998.v136.90408","article-title":"Inflammatory profile in unstable angina versus stable angina in patients undergoing percutaneous interventions","volume":"136","author":"Yazdani","year":"1998","journal-title":"Am. Heart J."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1016\/S0021-9150(01)00636-0","article-title":"Increased levels of monocyte-related cytokines in patients with unstable angina","volume":"161","author":"Hojo","year":"2002","journal-title":"Atherosclerosis"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"846","DOI":"10.1007\/s00380-015-0681-1","article-title":"Effect of exercise-based cardiac rehabilitation on non-culprit mild coronary plaques in the culprit coronary artery of patients with acute coronary syndrome","volume":"31","author":"Kurose","year":"2016","journal-title":"Heart Vessels"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1016\/j.jjcc.2009.01.004","article-title":"Effects of cardiac rehabilitation in patients with metabolic syndrome after coronary artery bypass grafting","volume":"53","author":"Onishi","year":"2009","journal-title":"J. Cardiol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"3152","DOI":"10.1161\/01.CIR.0000074229.93804.5C","article-title":"Regular physical activity improves endothelial function in patients with coronary artery disease by increasing phosphorylation of endothelial nitric oxide synthase","volume":"107","author":"Hambrecht","year":"2003","journal-title":"Circulation"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1016\/0735-1097(93)90051-2","article-title":"Various intensities of leisure time physical activity in patients with coronary artery disease: Effects on cardiorespiratory fitness and progression of coronary atherosclerotic lesions","volume":"22","author":"Hambrecht","year":"1993","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1840894","DOI":"10.1155\/2019\/1840894","article-title":"Cost-Effectiveness of Cardiac Rehabilitation in Patients with Coronary Artery Disease: A Meta-Analysis","volume":"2019","author":"Takura","year":"2019","journal-title":"Cardiol. Res. Pract."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/5\/1578\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:31:28Z","timestamp":1760175088000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/5\/1578"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,22]]},"references-count":26,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2020,5]]}},"alternative-id":["jcm9051578"],"URL":"https:\/\/doi.org\/10.3390\/jcm9051578","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2020,5,22]]}}}