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High-Density Lipoprotein Cholesterol and Cardiovascular Events in Patients with Stable Coronary Artery Disease Treated with Statins : An Observation from the REAL-CAD Study

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Title: High-Density Lipoprotein Cholesterol and Cardiovascular Events in Patients with Stable Coronary Artery Disease Treated with Statins : An Observation from the REAL-CAD Study
Authors: Omote, Kazunori Browse this author
Yokota, Isao Browse this author
Nagai, Toshiyuki Browse this author →KAKEN DB
Sakuma, Ichiro Browse this author
Nakagawa, Yoshihisa Browse this author
Kamiya, Kiwamu Browse this author
Iwata, Hiroshi Browse this author
Miyauchi, Katsumi Browse this author
Ozaki, Yukio Browse this author
Hibi, Kiyoshi Browse this author
Hiro, Takafumi Browse this author
Fukumoto, Yoshihiro Browse this author
Mori, Hiroyoshi Browse this author
Hokimoto, Seiji Browse this author
Ohashi, Yasuo Browse this author
Ohtsu, Hiroshi Browse this author
Ogawa, Hisao Browse this author
Daida, Hiroyuki Browse this author
Iimuro, Satoshi Browse this author
Shimokawa, Hiroaki Browse this author
Saito, Yasushi Browse this author
Kimura, Takeshi Browse this author
Matsuzaki, Masunori Browse this author
Nagai, Ryozo Browse this author
Anzai, Toshihisa Browse this author →KAKEN DB
Keywords: Lipids
Secondary prevention
Stable coronary artery disease
High-density lipoprotein cholesterol
Issue Date: 1-Jan-2022
Publisher: Japan Atherosclerosis Society (日本動脈硬化学会) JAS
Journal Title: Journal of atherosclerosis and thrombosis
Volume: 29
Issue: 1
Start Page: 50
End Page: 68
Publisher DOI: 10.5551/jat.59881
Abstract: Aim: The association between high-density lipoprotein cholesterol (HDL-C) level after statin therapy and cardiovascular events in patients with stable coronary artery disease (CAD) remains unclear. Thus, in this study, we sought to determine how HDL-C level after statin therapy is associated with cardiovascular events in stable CAD patients. Methods: From the REAL-CAD study which had shown the favorable prognostic effect of high-dose pitavastatin in stable CAD patients with low-density lipoprotein cholesterol (LDL-C) <120 mg/dL, 9,221 patients with HDL-C data at baseline and 6 months, no occurrence of primary outcome at 6 months, and reported non-adherence for pitavastatin, were examined. The primary outcome was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal ischemic stroke, or unstable angina requiring emergent admission after 6 months of randomization. Absolute difference and ratio of HDL-C levels were defined as (those at 6 months-at baseline) and (absolute difference/baseline) x 100, respectively. Results: During a median follow-up period of 4.0 (IQR 3.2-4.7) years, the primary outcome occurred in 417 (4.5%) patients. The adjusted risk of all HDL-C-related variables (baseline value, 6-month value, absolute, and relative changes) for the primary outcome was not significant (hazard ratio [HR] 0.99, 95% confidence interval [CI] 0.91-1.08, HR 1.03, 95% CI 0.94-1.12, HR 1.05, 95% CI 0.98-1.12, and HR 1.08, 95% CI 0.94-1.24, respectively). Furthermore, adjusted HRs of all HDL-C-related variables remained non-significant for the primary outcome regardless of on-treatment LDL-C level at 6 months. Conclusions: After statin therapy with modestly controlled LDL-C, HDL-C level has little prognostic value in patients with stable CAD.
Type: article
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

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