Can Intensive Lipid-Lowering Therapy Improve the Carotid Intima-Media Thickness in Japanese Subjects Under Primary Prevention for Cardiovascular Disease?: The JART and JART Extension Subanalysis

Hiroyuki Daida; Ryuji Nohara; Mitsumasa Hata; Kohei Kaku; Ryuzo Kawamori; Junji Kishimoto; Masahiko Kurabayashi; Izuru Masuda; Ichiro Sakuma; Tsutomu Yamazaki; Hiroyoshi Yokoi; Masayuki Yoshida; The Justification for Atherosclerosis Regression Treatment (JART) Investigators

doi:10.5551/jat.19109

Original Article

Can Intensive Lipid-Lowering Therapy Improve the Carotid Intima-Media Thickness in Japanese Subjects Under Primary Prevention for Cardiovascular Disease?: The JART and JART Extension Subanalysis

Hiroyuki Daida, Ryuji Nohara, Mitsumasa Hata, Kohei Kaku, Ryuzo Kawamori, Junji Kishimoto, Masahiko Kurabayashi, Izuru Masuda, Ichiro Sakuma, Tsutomu Yamazaki, Hiroyoshi Yokoi, Masayuki Yoshida, The Justification for Atherosclerosis Regression Treatment (JART) Investigators

Author information

Hiroyuki Daida
Department of Cardiology, Juntendo University, Graduate School of Medicine
Ryuji Nohara
Federation of National Public Service Personnel Mutual Aid Associations, Hirakata Kohsai Hospital
Mitsumasa Hata
Department of Cardiovascular Surgery, Nihon University School of Medicine
Kohei Kaku
Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, Kawasaki Medical School
Ryuzo Kawamori
Sportology Center, Juntendo University Graduate School of Medicine, Tokyo, supported by High Technology Research Center Grant from the Ministry of Education, Culture, Sports, Science and Technology of Japan
Junji Kishimoto
Center for Clinical and Translational Research, Kyushu University Hospital
Masahiko Kurabayashi
Department of Medicine and Biological Science, Gunma University Graduate School of Medicine
Izuru Masuda
Takeda Hospital, Medical Examination Center
Ichiro Sakuma
Hokko Memorial Clinic Caress Sapporo
Tsutomu Yamazaki
Clinical Research Support Center, the University of Tokyo Hospital
Hiroyoshi Yokoi
Department of Cardiology, Kokura Memorial Hospital
Masayuki Yoshida
Department of Life Sciences and Bioethics, Graduate School of Medicine, Tokyo Medical and Dental University
The Justification for Atherosclerosis Regression Treatment (JART) Investigators

Keywords: Carotid intima-media thickness, Primary prevention, Atherosclerosis, Intensive statin therapy, Rosuvastatin

JOURNAL OPEN ACCESS

2014 Volume 21 Issue 7 Pages 739-754

DOI https://doi.org/10.5551/jat.19109

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Details

Abstract

Aim: This subanalysis aimed to clarify whether intensive lipid-lowering therapy with statins slows the progression of atherosclerosis in Japanese subjects under treatment for primary prevention of cardiovascular disease.
Methods: This was a subanalysis of the Justification for Atherosclerosis Regression Treatment (JART) Study. We compared the efficacy of intensive lipid-lowering therapy and conventional therapy with respect to changes in the mean intima-media thickness (IMT) and serum lipid levels. We also evaluated changes in the mean IMT over 24 months of treatment and assessed the relationship between these changes and reductions in the LDL-C levels using a post-hoc analysis.
Results: Intensive lipid-lowering therapy with rosuvastatin was associated with significantly smaller changes in the mean IMT and a greater reduction in the serum lipid levels in comparison to conventional therapy with pravastatin. The average net change in the mean IMT was 0.010 mm (n=121) at 12 months and −0.004 mm (n=56) at 24 months. A decrease in LDL-C was found to be associated with a smaller change in the mean IMT (p=0.0009; Jonckheere-Terpstra trend test). A greater reduction in serum LDL-C was found to be associated with a smaller change in the mean IMT. Similar associations were observed for the serum TC and non-HDL-C levels and LDL-C/HDL-C ratio. There were no notable differences in the incidence of serious adverse events among the LDL-C quartiles.
Conclusions: Lowering the LDL-C level with intensive lipid-lowering therapy is associated with reduced changes in the IMT among Japanese subjects at moderate to high risk under treatment for primary prevention. Subjects suitable for primary prevention may receive cardiovascular benefits from intensive lipid-lowering therapy, in association with significantly slower IMT progression than that observed with conventional therapy.

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