Effects of Pravastatin on Exercise Electrocardiography Test Performance and Cardiovascular Mortality and Morbidity in Patients With Hypercholesterolemia : Lipid Intervention Study in Kyoto

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概要

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• The long-term effects of the 3-hydoxy-3-methyl-glutaryl coenzyme A reductase inhibitor, pravastatin, on exercise electrocardiography(ECG)test performance and cardiovascular mortality and morbidity were compared with those of conventional lipid-lowering drugs in hypercholesterolemic patients with no history of myocardial infarction or stroke. One thousand two hundred and seventeen patients were randomly assigned with mean serum cholestero1, triglyceride, high-density lipoprotein(HDL)cholesterol, and low-density lipoprotein(LDL)cholesterol levels of 6.98±0.91 mmol/L, 2.08±1.87mmol/L, 1.38±0.44mmol/L, and 5.07±1.14mmol/L, respectively, and received either pravastatin at a dose of 10-20mg/day(group P)or one of the conventional lipid-lowering drugs such as fibrtaes, nicotinic acid, and probucol(group C). The numbers of patients available for analysis in groups Pand C were 305 and 278 at year 1, 261 and 216 at year 2, 206 and 184 at year 3, 159 and 122 at year 4, and 103 and 81 at year 5. Over the 3.2 year mean follow-up period, the reduction in serum LDL cholesterol levels was significantly greater(p<0.01)in group P(-24.3%)than in group C(-16.0%). Serum HDL cholesterol levels increased in group P(+11.6%), bnt decreased in group C(-0.3%)(p<0.01). There were no significant differences in the rate of patients who exhibited ischemic changes to exercise ECG test(ischemic responders)between the 2 groups. Coronary heart diseases(CHD)occurred in 6 patients in group P and 13 in group C ; pravastatin significantly reduced CHD risk(reduction rate 0.369 ; 95% confidence interval 0.140-0.970 ; p<0.05). No significant differences existed between the treatment groups in terms of the number of strokes(group P, 6 ; group C, 7)or deaths unrelated to CHD(group P, 3 ; group C, 2). Although pravastatin did not improve the proportion of ischemic responders on exercise testing, it reduced CHD risk and serum LDL cholesterol levels more significantly than conventional lipid-lowering drugs without adversely affecting the risk of stroke and non-CHD death in hypercholesterolemic patients.

• 2001-12-20

著者

• TAKEDA Kazuo

  Kyoto Industrial Health Association

• Nakagawa Masao

  Second Department Of Internal Medicine Kyoto Prefectural University Of Medicine

• Azuma A

  Department Of Cardiology National Shiga Hospital

• Azuma Akihiro

  Second Department of Medicine, Kyoto Prefectural University of Medicine

• Nakagawa Masao

  Second Department Of Medicine Kyoto Prefectural University Of Medicine

• Nakata Tetsuo

  Department Of Cardiovascular Medicine Nantan General Hospital

• Takeda K

  Kyoto Industrial Health Association

• SASAKI Susumu

  Second Department of Internal Medicine. Kyoto Prefectural University of Medicine

• TAKEDA Kazuo

  Second Department of Internal Medicine. Kyoto Prefectural University of Medicine

• Sasaki Susumu

  Department Of Medicine Akashi City Hospital

• Asayama Jun

  Department of Clinical Pharmacology, Kyoto Pharmaceutical University

• Azuma Akihiro

  The Second Department Of Medicine Kyoto Prefectural University Of Medicine

• Sawada Shohei

  Second Department of Medicine, Kyoto Prefectural University of Medicine

• Asayama Jun

  Department Of Clinical Pharmacology Kyoto Pharmaceutical University

• Asayama Jun

  Department Of Internal Medicine Kyoto Prefectural University Of Medicine

• Asayama Jun

  Department Of Cardiology National Sgiga Hospital

• Nakagawa M

  Second Department Of Medicine Kyoto Prefectural University Of Medicine

• Nakata Tetsuo

  Second Department Of Medicine Kyoto Prefectural University Of Medicine

• Sawada Shohei

  Second Department Of Medicine Kyoto Prefectural University Of Medicine

• Nakata Tetsuo

  Department Of Cardiovascular Medicine Kyoto Prefectural University Of Medicine

• Nakamura T

  Second Department Of Medicine Kyoto Prefectural University Of Medicine

• Sasaki Susumu

  Division Of Hypertension And Nephrology Department Of Medicine Kyoto Prefectural University School O

• Sasaki Susumu

  Second Department Of Internal Medicine Kyoto Prefectural University Of Medicine

• Azuma Akihiro

  Second Department Of Medicine Kyoto Prefectural University Of Medicine

• Nakagawa Masao

  Second Department Of Internal Medicine Kyoto Prefectural Medical College

• Nakagawa Tatsuya

  Second Department Of Medicine Kyoto Prefectural University Of Medicine

• TAKEDA Kazuo

  Second Department of Internal Medicine, Kyoto Prefectural University of Medicine

• AZUMA Akihiro

  Second Department of Medicine and, Kyoto Prefectural University of Medicine

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