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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
Hyperlipidemia
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)

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