論文

2021年12月9日

Small Dense Low-Density Lipoprotein Cholesterol and Cardiovascular Risk in Statin-Treated Patients with Coronary Artery Disease.

Journal of atherosclerosis and thrombosis
  • Junnichi Ishii
  • ,
  • Kosuke Kashiwabara
  • ,
  • Yukio Ozaki
  • ,
  • Hiroshi Takahashi
  • ,
  • Fumihiko Kitagawa
  • ,
  • Hideto Nishimura
  • ,
  • Hideki Ishii
  • ,
  • Satoshi Iimuro
  • ,
  • Hideki Kawai
  • ,
  • Takashi Muramatsu
  • ,
  • Hiroyuki Naruse
  • ,
  • Hiroshi Iwata
  • ,
  • Sadako Tanizawa-Motoyama
  • ,
  • Hiroyasu Ito
  • ,
  • Eiichi Watanabe
  • ,
  • Yutaka Matsuyama
  • ,
  • Yoshihiro Fukumoto
  • ,
  • Ichiro Sakuma
  • ,
  • Yoshihisa Nakagawa
  • ,
  • Kiyoshi Hibi
  • ,
  • Takafumi Hiro
  • ,
  • Seiji Hokimoto
  • ,
  • Katsumi Miyauchi
  • ,
  • Hiroshi Ohtsu
  • ,
  • Hideo Izawa
  • ,
  • Hisao Ogawa
  • ,
  • Hiroyuki Daida
  • ,
  • Hiroaki Shimokawa
  • ,
  • Yasushi Saito
  • ,
  • Takeshi Kimura
  • ,
  • Masunori Matsuzaki
  • ,
  • Ryozo Nagai

記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.5551/jat.63229

AIM: We investigated the relationship between small dense low-density cholesterol (sdLDL-C) and risk of major adverse cardiovascular events (MACE) in patients treated with high- or low-dose statin therapy. METHODS: This was a prospective case-cohort study within the Randomized Evaluation of Aggressive or Moderate Lipid-Lowering Therapy with Pitavastatin in Coronary Artery Disease (REAL-CAD) study, a randomized trial of high- or low-dose (4 or 1 mg/d pitavastatin, respectively) statin therapy, in patients with stable coronary artery disease (CAD). Serum sdLDL-C was determined using an automated homogenous assay at baseline (randomization after a rule-in period, >1 month with 1 mg/d pitavastatin) and 6 months after randomization, in 497 MACE cases, and 1543 participants randomly selected from the REAL-CAD study population. RESULTS: High-dose pitavastatin reduced sdLDL-C by 20% than low-dose pitavastatin (p for interaction <0.001). Among patients receiving low-dose pitavastatin, baseline sdLDL-C demonstrated higher MACE risk independent of LDL-C (hazard ratio [95% confidence interval], 4th versus 1st quartile, 1.67 [1.04-2.68]; p for trend=0.034). High-dose (versus low-dose) pitavastatin reduced MACE risk by 46% in patients in the highest baseline sdLDL-C quartile (>34.3 mg/dL; 0.54 [0.36-0.81]; p=0.003), but increased relative risk by 40% in patients with 1st quartile (≤ 19.5 mg/dL; 1.40 [0.94-2.09]; p=0.099) and did not alter risk in those in 2nd and 3rd quartiles (p for interaction=0.002). CONCLUSIONS: These findings associate sdLDL-C and cardiovascular risk, independent of LDL-C, in statin-treated CAD patients. Notably, high-dose statin therapy reduces this risk in those with the highest baseline sdLDL-C.

リンク情報
DOI
https://doi.org/10.5551/jat.63229
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/34880156
ID情報
  • DOI : 10.5551/jat.63229
  • PubMed ID : 34880156

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