Intensive lipid-lowering therapy for slowing progression as well as inducing regression of atherosclerosis in Japanese patients: subanalysis of the JART study

Int Heart J. 2013;54(1):33-9. doi: 10.1536/ihj.54.33.

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.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anticholesteremic Agents / administration & dosage
  • Anticholesteremic Agents / adverse effects
  • Atherosclerosis* / diagnosis
  • Atherosclerosis* / epidemiology
  • Atherosclerosis* / etiology
  • Atherosclerosis* / physiopathology
  • Atherosclerosis* / prevention & control
  • Carotid Intima-Media Thickness
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Disease Progression
  • Female
  • Fluorobenzenes* / administration & dosage
  • Fluorobenzenes* / adverse effects
  • Humans
  • Hypercholesterolemia / complications
  • Hypercholesterolemia / drug therapy*
  • Hypercholesterolemia / epidemiology
  • Hypercholesterolemia / metabolism
  • Japan / epidemiology
  • Lipid Metabolism / drug effects
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Pharmacovigilance
  • Pravastatin* / administration & dosage
  • Pravastatin* / adverse effects
  • Preventive Health Services / methods
  • Preventive Health Services / standards
  • Pyrimidines* / administration & dosage
  • Pyrimidines* / adverse effects
  • Risk Assessment
  • Rosuvastatin Calcium
  • Sulfonamides* / administration & dosage
  • Sulfonamides* / adverse effects
  • Treatment Outcome

Substances

  • Anticholesteremic Agents
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Fluorobenzenes
  • Pyrimidines
  • Sulfonamides
  • Rosuvastatin Calcium
  • Pravastatin