title: 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).
abstract: 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.
authors.affiliation: Nippon Medical School, Department of Medicine, 1-1-5 Sendagi, Bunkyoku, Tokyo 113-8603, Japan. shinichi@nms.ac.jp
authors.forename: Shinichi
authors.initials: S
authors.lastname: Oikawa
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yokoyama
authors.forename: Hideki
authors.initials: H
authors.lastname: Origasa
authors.forename: Masunori
authors.initials: M
authors.lastname: Matsuzaki
authors.forename: Yuji
authors.initials: Y
authors.lastname: Matsuzawa
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Saito
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Jun
authors.initials: J
authors.lastname: Sasaki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hishida
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Itakura
authors.forename: Toru
authors.initials: T
authors.lastname: Kita
authors.forename: Akira
authors.initials: A
authors.lastname: Kitabatake
authors.forename: Noriaki
authors.initials: N
authors.lastname: Nakaya
authors.forename: Toshiie
authors.initials: T
authors.lastname: Sakata
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Shimada
authors.forename: Kunio
authors.initials: K
authors.lastname: Shirato
mesh_terms: 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
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D015118:Eicosapentaenoic Acid