title: Intensive lipid-lowering therapy for slowing progression as well as inducing regression of atherosclerosis in Japanese patients: subanalysis of the JART study.
abstract: This paper describes a subanalysis of the JART Study comparing rosuvastatin and pravastatin treatment. A total of 314 subjects were analyzed in this subanalysis, 282 of whom were eligible for evaluation of the relationship between LDL-C and carotid mean-IMT change. In the subanalysis, we evaluated the extent to which intensive lipid-lowering therapy slowed the mean-IMT progression by a correlation analysis between LDL-C and mean-IMT change after 12 months of statin treatment. Nearly half were male (49.4%) and elderly (49.7%). The majority (84.4%) were treated for primary prevention. Patients with hypertension and diabetes mellitus accounted for 65.3% and 44.0%, respectively. At the 12-month measurement point, mean-IMT change was correlated with LDL-C (R = 0.187; P = 0.0016), LDL-C/ HDL-C ratio (R = 0.152; P = 0.0105), and non-HDL-C (R = 0.132; P = 0.0259). Mean-IMT after 12 months was divided into 4 subgroups by LDL-C at 12 months; < 80, ≥ 80 to < 100, ≥ 100 to < 120, and ≥ 120 mg/dL. A trend analysis using the Jonckheere-Terpstra test showed statistical signifi cance (P = 0.0002). Even for prevention in Japanese patients who have lower risk of atherosclerotic disease than Western patients, lowering the LDL-C level to below the therapeutic target prevented mean-IMT progression after 12 months more strongly. These findings suggest that more intensive control of LDL-C to levels lower than those in current JAS guidelines should be required to achieve slowing of progression as well as induction of regression of atherosclerosis.
authors: Clinical Research Support Center, The University of Tokyo Hospital, Tokyo, Japan.
authors: Tsutomu
authors: T
authors: Yamazaki
authors: Ryuji
authors: R
authors: Nohara
authors: Hiroyuki
authors: H
authors: Daida
authors: Mitsumasa
authors: M
authors: Hata
authors: Kohei
authors: K
authors: Kaku
authors: Ryuzo
authors: R
authors: Kawamori
authors: Junji
authors: J
authors: Kishimoto
authors: Masahiko
authors: M
authors: Kurabayashi
authors: Izuru
authors: I
authors: Masuda
authors: Ichiro
authors: I
authors: Sakuma
authors: Hiroyoshi
authors: H
authors: Yokoi
authors: Masayuki
authors: M
authors: Yoshida
mesh_terms: D000368:Aged; D000924:Anticholesteremic Agents / Q000008:administration & dosage / Q000009:adverse effects; D050197:Atherosclerosis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D059168:Carotid Intima-Media Thickness; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D018450:Disease Progression; D005260:Female; D005464:Fluorobenzenes / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000378:metabolism; D007564:Japan / Q000453:epidemiology; D050356:Lipid Metabolism / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D060735:Pharmacovigilance; D017035:Pravastatin / Q000008:administration & dosage / Q000009:adverse effects; D011314:Preventive Health Services / Q000379:methods / Q000592:standards; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects; D018570:Risk Assessment; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000008:administration & dosage / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D000924:Anticholesteremic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D005464:Fluorobenzenes; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium; D017035:Pravastatin