title: Can intensive lipid-lowering therapy improve the carotid intima-media thickness in Japanese subjects under primary prevention for cardiovascular disease?: The JART and JART extension subanalysis.
abstract: OBJECTIVE
  This subanalysis aimed to clarify whether intensive lipid-lowering therapy with statins slows the progression of atherosclerosis in Japanese subjects under treatment for primary prevention of cardiovascular disease.
  
  
  METHODS
  This was a subanalysis of the Justification for Atherosclerosis Regression Treatment (JART) Study. We compared the efficacy of intensive lipid-lowering therapy and conventional therapy with respect to changes in the mean intima-media thickness (IMT) and serum lipid levels. We also evaluated changes in the mean IMT over 24 months of treatment and assessed the relationship between these changes and reductions in the LDL-C levels using a post-hoc analysis.
  
  
  RESULTS
  Intensive lipid-lowering therapy with rosuvastatin was associated with significantly smaller changes in the mean IMT and a greater reduction in the serum lipid levels in comparison to conventional therapy with pravastatin. The average net change in the mean IMT was 0.010 mm (n=121) at 12 months and -0.004 mm (n=56) at 24 months. A decrease in LDL-C was found to be associated with a smaller change in the mean IMT (p=0.0009; Jonckheere-Terpstra trend test). A greater reduction in serum LDL-C was found to be associated with a smaller change in the mean IMT. Similar associations were observed for the serum TC and non-HDL-C levels and LDL-C/HDL-C ratio. There were no notable differences in the incidence of serious adverse events among the LDL-C quartiles.
  
  
  CONCLUSIONS
  Lowering the LDL-C level with intensive lipid-lowering therapy is associated with reduced changes in the IMT among Japanese subjects at moderate to high risk under treatment for primary prevention. Subjects suitable for primary prevention may receive cardiovascular benefits from intensive lipid-lowering therapy, in association with significantly slower IMT progression than that observed with conventional therapy.
authors: Department of Cardiology, Juntendo University, Graduate School of Medicine.
authors: Hiroyuki
authors: H
authors: Daida
authors: Ryuji
authors: R
authors: Nohara
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: Tsutomu
authors: T
authors: Yamazaki
authors: Hiroyoshi
authors: H
authors: Yokoi
authors: Masayuki
authors: M
authors: Yoshida
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000503:physiopathology / Q000517:prevention & control*; D059168:Carotid Intima-Media Thickness; D018450:Disease Progression; D005260:Female; D005464:Fluorobenzenes / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D050356:Lipid Metabolism / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention; D011743:Pyrimidines / Q000627:therapeutic use*; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium