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タイトル: Large scale cohort study of the relationship between serum cholesterol concentration and coronary events with low-dose simvastatin therapy in Japanese patients with hypercholesterolemia - Primary prevention cohort study of the Japan lipid intervention trial (J-LIT)
著者: Matsuzaki, Masunori
Kita, Toru
Mabuchi, Hiroshi link image
Matsuzawa, Yuji
Nakaya, Noriaki
Oikawa, Shinichi
Saito, Yasushi
Sasaki, Jun
Shimamoto, Kazuaki
Itakura, Hiroshige
松崎, 益徳
馬渕, 宏
発行日: 2002年12月
出版社(者): 日本循環器学会
雑誌名: Circulation Journal
ISSN: 1346-9843
巻: 66
号: 12
開始ページ: 1087
終了ページ: 1095
キーワード: Cholesterol-lowering medication
Coronary heart disease
Longitudinal study
Risk factors
抄録: Hyperlipidemia is a well-established risk factor for primary coronary heart disease (CHD). Although simvastatin is known to lower serum lipid concentrations, the protective effect of such lipid-lowering therapy against primary CHD has not been established in Japanese patients with hypercholesterolemia. The Japan Lipid Intervention Trial was a 6-year, nationwide cohort study of 47,294 patients treated with open-labeled simvastatin (5-10 mg/day) and monitored by physicians under standard clinical conditions. The aim of the study was to determine the relationship between the occurrence of CHD and the serum lipid concentrations during low-dose simvastatin treatment. Simvastatin reduced serum concentrations of total cholesterol (TC), low-density lipoprotein- cholesterol (LDL-C) and triglyceride (TG), by 18.4%, 26.8% and 16.1% on average, respectively, during the treatment period. The risk of coronary events was higher when the average TC concentration was ≥240 mg/dl and the average LDL-C concentration was ≥160mg/dl. The incidence of coronary events increased in the patients with TG concentration ≥300 mg/dl compared with patients with TG concentration <150 mg/dl. The high-density lipoprotein cholesterol (HDL-C) inversely correlated with the risk of coronary events. The J-curve association was observed between average TC or LDL-C concentrations and total mortality. Malignancy was the most prevalent cause of death. The health of patients should be monitored closely when there is a remarkable decrease in TC and LDL-C concentrations with low-dose statin. A reasonable strategy to prevent coronary events in Japanese hypercholesterolemic patients without prior CHD under low-dose statin treatment might be regulating the serum lipid concentrations to at least <240 mg/dl for TC, <160 mg/dl for LDL-C, ≅300 mg/dl for TG, and >40 mg/dl for HDL-C.
DOI: 10.1253/circj.66.1087
URI: http://hdl.handle.net/2297/7526
関連URI: http://www.jstage.jst.go.jp/article/circj/66/12/66_1087/_article/-char/en
資料種別: Journal Article
版表示: publisher
出現コレクション:1. 査読済論文(医学・保健)

このアイテムを引用あるいはリンクする場合は次の識別子を使用してください。 http://hdl.handle.net/2297/7526



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