title: Impact of combined lipid lowering with blood pressure control on coronary plaque regression: rationale and design of MILLION study.
abstract: A line of epidemiological studies suggests that the accumulation of coronary risk factors promotes the progression of coronary atherosclerosis. Recent clinical studies showed that aggressive low-density lipoprotein (LDL) cholesterol-lowering therapy using statins could regress coronary atheroma and reduce major cardiovascular events. Additionally, therapy that controlled amlodipine-based blood pressure reduced major cardiovascular events in patients with hypertension compared with an atenolol-based regimen. An open-label randomized multicenter study is primarily planned to evaluate the changes in coronary atheroma volume using intravascular ultrasonography 18-24 months after intensive lowering of LDL-cholesterol and blood pressure compared with a standard therapy indicated by current guidelines in Japanese patients with coronary artery disease (CAD). The secondary endpoints include changes in serum lipid levels, inflammatory markers, glucose markers and blood pressure. In total, 100 subjects with CAD who are undergoing percutaneous coronary intervention will be tested. The MILLION study will provide new evidence and therapeutic standards for the prevention of CAD in Japanese patients by controlling both LDL-C levels and blood pressure.
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.
authors.forename: Masa-Aki
authors.initials: MA
authors.lastname: Kawashiri
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Sakata
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.
authors.forename: Tadatsugu
authors.initials: T
authors.lastname: Gamou
authors.affiliation: Department of Cardiology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
authors.forename: Honin
authors.initials: H
authors.lastname: Kanaya
authors.affiliation: Department of Cardiology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Miwa
authors.affiliation: Department of Internal Medicine, Komatsu Municipal Hospital, Komatsu, Japan.
authors.forename: Kosei
authors.initials: K
authors.lastname: Ueda
authors.affiliation: Department of Internal Medicine, Komatsu Municipal Hospital, Komatsu, Japan.
authors.forename: Toshinori
authors.initials: T
authors.lastname: Higashikata
authors.affiliation: Department of Cardiology, Fukui Cardiovascular Center, Fukui, Japan.
authors.forename: Sumio
authors.initials: S
authors.lastname: Mizuno
authors.affiliation: Department of Internal Medicine, Yokohama Sakae Kyosai Hospital, Yokohama, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Michishita
authors.affiliation: Department of Cardiology, Kanazawa Cardiovascular Hospital, Kanazawa, Japan.
authors.forename: Masanobu
authors.initials: M
authors.lastname: Namura
authors.affiliation: Department of Cardiology, Toyama Red Cross Hospital, Toyama, Japan.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Nitta
authors.affiliation: Department of Cardiology, Toyama Red Cross Hospital, Toyama, Japan.
authors.forename: Shoji
authors.initials: S
authors.lastname: Katsuda
authors.affiliation: Department of Cardiology, Koseiren Takaoka Hospital, Takaoka, Japan.
authors.forename: Kazuyasu
authors.initials: K
authors.lastname: Okeie
authors.affiliation: Department of Internal Medicine, Takaoka Municipal Hospital, Takaoka, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Hirase
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.
authors.forename: Hayato
authors.initials: H
authors.lastname: Tada
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.
authors.forename: Katsuharu
authors.initials: K
authors.lastname: Uchiyama
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Konno
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.
authors.forename: Kenshi
authors.initials: K
authors.lastname: Hayashi
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, 920-8641, Japan.
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Ino
authors.affiliation: Division of Medical Sciences, Kanazawa University Graduate School of Medicine, Kanazawa, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Nagase
authors.affiliation: Cardiovascular Imaging Center, Toyohashi, Japan.
authors.forename: Mitsuyasu
authors.initials: M
authors.lastname: Terashima
authors.affiliation: Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, 920-8641, Japan. myamagi@med.kanazawa-u.ac.jp.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamagishi
mesh_terms: D017311:Amlodipine / Q000627:therapeutic use*; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D018450:Disease Progression; D004338:Drug Combinations; D005500:Follow-Up Studies; D006538:Heptanoic Acids / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008055:Lipids / Q000097:blood*; D058226:Plaque, Atherosclerotic / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D011446:Prospective Studies; D011758:Pyrroles / Q000627:therapeutic use*; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D004338:Drug Combinations; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids; D011758:Pyrroles; C487936:amlodipine, atorvastatin drug combination; D017311:Amlodipine
keywords: Amlodipine; Atorvastatin; Coronary plaque volume; Intravascular ultrasonography (IVUS)