Journal
JOURNAL OF CARDIOLOGY
Volume 67, Issue 3-4, Pages 340-346Publisher
ELSEVIER
DOI: 10.1016/j.jjcc.2015.05.017
Keywords
HMG-CoA reductase inhibitor; Small-dense low-density lipoprotein; Malondialdehyde; High-sensitivity C-reactive protein; High-dose statin therapy
Categories
Funding
- AstraZeneca
- Astellas Pharma Inc
- Nippon Boehringer Ingelheim Co, Ltd
- Pfizer Inc
- MSD K.K.
- Daiichi Sankyo Company, Ltd
- Kowa Pharmaceutical Co, Ltd
- Takeda Pharmaceutical Co, Ltd
- Novartis Pharmaceuticals Japan
- Mitsubishi Tanabe Pharma Corporation
- Dainippon Sumitomo Pharma Co, Ltd
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Background: Cardiovascular events (CV) continue to occur due to residual risks in high-risk patients in spite of substantial reductions in the low-density lipoprotein cholesterol (LDL) with statins. It has been reported that the small-dense LDL (sd-LDL) components of high atherogenic particles are associated with an increased risk of CV, more than large buoyant LDL. However, there are few reports regarding the effects of high-dose statin therapy in improving atherogenic lipoproteins. Methods and results: In this prospective, randomized, open-label, multicenter study, a total of 111 high-risk patients were randomly assigned to two groups. In the high-dose therapy group, 58 patients were administered 5 mg of rosuvastatin per day for four weeks, after which the dose was titrated to 10 mg for the following eight weeks. In the low-dose therapy group, 53 patients were given 2.5 mg for 12 weeks. We evaluated the lipid profiles, including the levels of sd-LDL, malondialdehyde-modified LDL-cholesterol (C) (MDA-LDL) as oxidized-LDL, and remnant-like particle-cholesterol. The LDL-C, non-high-density lipoprotein (HDL), and LDL-C/HDL-C ratio were decreased in the high-dose therapy group (p < 0.01). Moreover, the sd-LDL and MDA-LDL levels were significantly reduced in the high-dose therapy group (p < 0.05). There were no serious adverse events in either group. Conclusions: High-dose statin therapy significantly reduced the sd-LDL and MDA-LDL components of atherosclerotic lipoproteins without adverse events in comparison with low-dose statin therapy. (C) 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
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