Suppressive effect of EPA on the incidence of coronary events in hypercholesterolemia with impaired glucose metabolism: Sub-analysis of the Japan EPA Lipid Intervention Study (JELIS).
BACKGROUND
JELIS was a large-scale clinical trial that investigated the effects of eicosapentaenoic acid (EPA) on coronary artery disease (CAD). In this paper, the data of patients registered in JELIS were analysed to compare the incidence of CAD between patients with impaired glucose metabolism (IGM) and normoglycemic (NG) patients. The effect of EPA on the incidence of CAD in patients with IGM was also assessed.


METHODS
The 18,645 hypercholesterolemic patients registered in JELIS were divided into two groups. One group consisted of patients with IGM (n=4565), which included the patients who had diabetes mellitus and patients who had a fasting plasma glucose of 110mg/dL or higher, either at the time of registration or after 6 months. The other group consisted of NG patients (n=14,080). CAD incidence of the two groups over the average 4.6-year follow-up period was compared, and the effect of EPA was assessed.


RESULTS
Compared to NG patients, IGM patients had a significantly higher CAD hazard ratio (1.71 in the non-EPA group and 1.63 in the EPA group). The treatment with EPA resulted in a 22% decrease in the CAD incidence (P=0.048) in IGM patients and an 18% decrease (P=0.062) in NG patients.


CONCLUSIONS
It was found that the CAD risk in IGM patients is higher than in NG patients, and that highly purified EPA is very effective in decreasing the incidence of CAD among Japanese IGM patients, even though the intake of fish is high.
Oikawa
Shinichi
S
Nippon Medical School, Department of Medicine, 1-1-5 Sendagi, Bunkyoku, Tokyo 113-8603, Japan. shinichi@nms.ac.jp
Yokoyama
Mitsuhiro
M
Origasa
Hideki
H
Matsuzaki
Masunori
M
Matsuzawa
Yuji
Y
Saito
Yasushi
Y
Ishikawa
Yuichi
Y
Sasaki
Jun
J
Hishida
Hitoshi
H
Itakura
Hiroshige
H
Kita
Toru
T
Kitabatake
Akira
A
Nakaya
Noriaki
N
Sakata
Toshiie
T
Shimada
Kazuyuki
K
Shirato
Kunio
K
D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control*; D003920:Diabetes Mellitus / Q000188:drug therapy*; D015118:Eicosapentaenoic Acid / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D006937:Hypercholesterolemia / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D015118:Eicosapentaenoic Acid