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

Omote, Kazunori; Yokota, Isao; Nagai, Toshiyuki et al.

Journal of atherosclerosis and thrombosis, 2022, 29(1), 50-68

Permalink : https://hdl.handle.net/2115/84258

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https://doi.org/10.5551/jat.59881      

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アクセス権
metadata only access
URI
https://hdl.handle.net/2115/84258
タイトル
High-Density Lipoprotein Cholesterol and Cardiovascular Events in Patients with Stable Coronary Artery Disease Treated with Statins : An Observation from the REAL-CAD Study
著者
Omote, Kazunori ; Yokota, Isao ; Nagai, Toshiyuki ; Sakuma, Ichiro ; Nakagawa, Yoshihisa ; Kamiya, Kiwamu ; Iwata, Hiroshi ; Miyauchi, Katsumi ; Ozaki, Yukio ; Hibi, Kiyoshi ; Hiro, Takafumi ; Fukumoto, Yoshihiro ; Mori, Hiroyoshi ; Hokimoto, Seiji ; Ohashi, Yasuo ; Ohtsu, Hiroshi ; Ogawa, Hisao ; Daida, Hiroyuki ; Iimuro, Satoshi ; Shimokawa, Hiroaki ; Saito, Yasushi ; Kimura, Takeshi ; Matsuzaki, Masunori ; Nagai, Ryozo ; Anzai, Toshihisa
著者名
Omote, Kazunori
著者名
Yokota, Isao
e-Rad_Researcher
00528218
著者名
Nagai, Toshiyuki
著者名
Sakuma, Ichiro
著者名
Nakagawa, Yoshihisa
著者名
Kamiya, Kiwamu
著者名
Iwata, Hiroshi
著者名
Miyauchi, Katsumi
著者名
Ozaki, Yukio
著者名
Hibi, Kiyoshi
著者名
Hiro, Takafumi
著者名
Fukumoto, Yoshihiro
著者名
Mori, Hiroyoshi
著者名
Hokimoto, Seiji
著者名
Ohashi, Yasuo
著者名
Ohtsu, Hiroshi
著者名
Ogawa, Hisao
著者名
Daida, Hiroyuki
著者名
Iimuro, Satoshi
著者名
Shimokawa, Hiroaki
著者名
Saito, Yasushi
著者名
Kimura, Takeshi
著者名
Matsuzaki, Masunori
著者名
Nagai, Ryozo
e-Rad_Researcher
60232089
著者名
Anzai, Toshihisa
言語
英語
キーワード
Lipids
Secondary prevention
Stable coronary artery disease
Statin
High-density lipoprotein cholesterol
発行日
2022-01-01
出版者
Japan Atherosclerosis Society (日本動脈硬化学会) JAS
収録物名
Journal of atherosclerosis and thrombosis
巻(号)
29(1)
ページ
50-68
抄録
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.
資源タイプ
学術雑誌論文
出版タイプ
Version of Record
PISSN
1340-3478
関連情報 (isIdenticalTo)
出版社版DOI
https://doi.org/10.5551/jat.59881