Intensive Lipid-Lowering Therapy for Slowing Progression as Well as Inducing Regression of Atherosclerosis in Japanese Patients Subanalysis of the JART Study

Tsutomu Yamazaki; Ryuji Nohara; Hiroyuki Daida; Mitsumasa Hata; Kohei Kaku; Ryuzo Kawamori; Junji Kishimoto; Masahiko Kurabayashi; Izuru Masuda; Ichiro Sakuma; Hiroyoshi Yokoi; Masayuki Yoshida; for the Justification for Atherosclerosis Regression Treatment (JART) Investigators

doi:10.1536/ihj.54.33

Clinical Studies

Intensive Lipid-Lowering Therapy for Slowing Progression as Well as Inducing Regression of Atherosclerosis in Japanese Patients

Subanalysis of the JART Study

Tsutomu Yamazaki, Ryuji Nohara, Hiroyuki Daida, Mitsumasa Hata, Kohei Kaku, Ryuzo Kawamori, Junji Kishimoto, Masahiko Kurabayashi, Izuru Masuda, Ichiro Sakuma, Hiroyoshi Yokoi, Masayuki Yoshida, for the Justification for Atherosclerosis Regression Treatment (JART) Investigators

Author information

Tsutomu Yamazaki
Clinical Research Support Center, The University of Tokyo Hospital
Ryuji Nohara
Cardiovascular Center, Kitano Hospital, The Tazuke Kofukai Medical Research Institute
Hiroyuki Daida
Department of Cardiology, Juntendo University School of Medicine
Mitsumasa Hata
Department of Cardiovascular Surgery, Nihon University School of Medicine
Kohei Kaku
Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, Kawasaki Medical School
Ryuzo Kawamori
Sportology Center, Juntendo University Graduate School of Medicine, supported by High Technology Research Center Grant from the Ministry of Education, Culture, Sports, Science and Technology of Japan
Junji Kishimoto
Center for Clinical and Translational Research, Kyushu University Hospital
Masahiko Kurabayashi
Department of Medicine and Biological Science, Gunma University Graduate School of Medicine
Izuru Masuda
Takeda Hospital Medical Examination Center
Ichiro Sakuma
Hokko Memorial Clinic Caress Sapporo
Hiroyoshi Yokoi
Department of Cardiology, Kokura Memorial Hospital
Masayuki Yoshida
Department of Life Sciences and Bioethics, Graduate School of Medicine, Tokyo Medical and Dental University
for the Justification for Atherosclerosis Regression Treatment (JART) Investigators

Keywords: Carotid intima-media thickness, LDL-cholesterol, Dyslipidemia, JART Study, Regression analysis, Prognostic factor, Factor analysis

JOURNAL FREE ACCESS

2013 Volume 54 Issue 1 Pages 33-39

DOI https://doi.org/10.1536/ihj.54.33

J-STAGE : ihj 54 4 pp.246-246

Details

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.

Corresponding author

Register with J-STAGE for free!