Can Intensive Lipid-Lowering Therapy Improve the Carotid Intima-Media Thickness in Japanese Subjects Under Primary Prevention for Cardiovascular Disease?: The JART and JART Extension Subanalysis
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概要
- 論文の詳細を見る
Aim: This subanalysis aimed to clarify whether intensive lipid-lowering therapy with statins slows the progression of atherosclerosis in Japanese subjects under treatment for primary prevention of cardiovascular disease.Methods: This was a subanalysis of the Justification for Atherosclerosis Regression Treatment (JART) Study. We compared the efficacy of intensive lipid-lowering therapy and conventional therapy with respect to changes in the mean intima-media thickness (IMT) and serum lipid levels. We also evaluated changes in the mean IMT over 24 months of treatment and assessed the relationship between these changes and reductions in the LDL-C levels using a post-hoc analysis.Results: Intensive lipid-lowering therapy with rosuvastatin was associated with significantly smaller changes in the mean IMT and a greater reduction in the serum lipid levels in comparison to conventional therapy with pravastatin. The average net change in the mean IMT was 0.010 mm (n=121) at 12 months and −0.004 mm (n=56) at 24 months. A decrease in LDL-C was found to be associated with a smaller change in the mean IMT (p=0.0009; Jonckheere-Terpstra trend test). A greater reduction in serum LDL-C was found to be associated with a smaller change in the mean IMT. Similar associations were observed for the serum TC and non-HDL-C levels and LDL-C/HDL-C ratio. There were no notable differences in the incidence of serious adverse events among the LDL-C quartiles.Conclusions: Lowering the LDL-C level with intensive lipid-lowering therapy is associated with reduced changes in the IMT among Japanese subjects at moderate to high risk under treatment for primary prevention. Subjects suitable for primary prevention may receive cardiovascular benefits from intensive lipid-lowering therapy, in association with significantly slower IMT progression than that observed with conventional therapy.
- 一般社団法人 日本動脈硬化学会の論文
著者
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Kaku Kohei
Division Of Diabetes And Endocrinology Department Of Internal Medicine Kawasaki Medical School
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Daida Hiroyuki
Department Of Cardiology
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Hata Mitsumasa
Department Of Cardiac Surgery Austin & Repatriation Medical Centre University Of Melbourne
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Kurabayashi Masahiko
Department Of Cardiology Kanazawa Medical University
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Kawamori Ryuzo
Sportology Center Juntendo University Graduate School Of Medicine
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Yokoi Hiroyoshi
Department Of Cardiac Rehabilitation Kokura Memorial Hospital
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Yoshida Masayuki
Department Of Applied Genetics Medical Research Institute Tokyo Medical And Dental University
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Sakuma Ichiro
Hokko Memorial Clinic Caress Sapporo
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Kishimoto Junji
Center For Clinical And Translational Research Kyushu University Hospital
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Masuda Izuru
Takeda Hospital Medical Examination Center
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Yamazaki Tsutomu
Clinical Bioinformatics, University of Tokyo Graduate School of Medicine
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Nohara Ryuji
Federation of National Public Service Personnel Mutual Aid Associations, Hirakata Kohsai Hospital
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