title: Relationship between coronary artery disease and non-HDL-C, and effect of highly purified EPA on the risk of coronary artery disease in hypercholesterolemic patients treated with statins: sub-analysis of the Japan EPA Lipid Intervention Study (JELIS).
abstract: OBJECTIVE
  The present study examined the importance of reducing non-high-density lipoprotein cholesterol (non-HDL-C) for the primary prevention of the occurrence of coronary artery disease (CAD) in the JELIS, and the effects of EPA.
  
  
  METHODS
  The patients were distributed into 4 subgroups using the lipid management goal for LDL-C recommended by the Japan Atherosclerosis Society guideline (2007) and the goal for non-HDL-C defined as 30 mg/dL higher than LDL-C: A) achieved both goals; B) achieved the LDL-C but not non-HDL-C goal; C) achieved the non-HDL-C but not LDL-C goal; and D) did not attain either goal. The incidences of CAD in the 4 subgroups were compared, and the effects of eicosapentaenoic acid (EPA) on the risk of CAD in these subgroups were examined.
  
  
  RESULTS
  In the non-EPA group, the incidence of CAD in patients who did not achieve the goals for LDL-C or non-HDL-C was higher than in patients who achieved those goals. Patients in subgroups B, C, and D were at higher risk for CAD than those in subgroup A (B, HR 2.31; C, HR 1.90; D, HR 2.47). EPA reduced the risk of CAD by 38% in subgroups B, C, and D (p= 0.007).
  
  
  CONCLUSIONS
  We reconfirmed non-HDL-C as a predictor of the risk for CAD and a residual risk marker of CAD after LDL-C-lowering therapy. EPA was useful to reduce the occurrence of CAD in patients who did not achieve the goals for LDL-C and/or non-HDL-C.
authors.affiliation: International University of Health and Welfare Graduate School of Public Health Medicine, Chuo-ku, Fukuoka, Japan. jsas@nifty.com
authors.forename: Jun
authors.initials: J
authors.lastname: Sasaki
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Yokoyama
authors.forename: Masunori
authors.initials: M
authors.lastname: Matsuzaki
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Saito
authors.forename: Hideki
authors.initials: H
authors.lastname: Origasa
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Ishikawa
authors.forename: Shinichi
authors.initials: S
authors.lastname: Oikawa
authors.forename: Hiroshige
authors.initials: H
authors.lastname: Itakura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hishida
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
authors.forename: Yuji
authors.initials: Y
authors.lastname: Matsuzawa
mesh_terms: D000328:Adult; D000368:Aged; D008076:Cholesterol, HDL / Q000378:metabolism*; D008078:Cholesterol, LDL / Q000378:metabolism*; D003324:Coronary Artery Disease / Q000139:chemically induced / Q000453:epidemiology / Q000517:prevention & control*; D015118:Eicosapentaenoic Acid / Q000494:pharmacology*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects*; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D017698:Postmenopause; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D015118:Eicosapentaenoic Acid