Effects of EPA on coronary artery disease in hypercholesterolemic patients with multiple risk factors: Sub-analysis of primary prevention cases from the Japan EPA Lipid Intervention Study (JELIS)

被引：257

作者：

Saito, Yasushi ^{[1
]}

Yokoyama, Mitsuhiro ^{[2
]}

Origasa, Hideki ^{[3
]}

Matsuzaki, Masunori ^{[4
]}

Matsuzawa, Yuji ^{[5
]}

Ishikawa, Yuichi ^{[6
]}

Oikawa, Shinichi ^{[7
]}

Sasaki, Jun ^{[8
]}

Hishida, Hitoshi ^{[9
]}

Itakura, Hiroshige ^{[10
]}

Kita, Toru ^{[11
]}

Kitabatake, Akira ^{[12
]}

Nakaya, Noriaki ^{[13
]}

Sakata, Toshiie ^{[14
]}

Shimada, Kazuyuki ^{[15
]}

Shirato, Kunio ^{[16
]}

机构：

[1] Chiba Univ, Grad Sch Med, Chiba, Japan

[2] Hyogo Prefectural Awaji Hosp, Sumoto, Hyogo, Japan

[3] Toyama Univ, Toyama 930, Japan

[4] Yamaguchi Univ, Grad Sch Med, Yamaguchi, Japan

[5] Sumitomo Hosp, Osaka, Japan

[6] Kobe Univ, Grad Sch Hlth Sci, Kobe, Hyogo 657, Japan

[7] Nippon Med Sch, Tokyo 113, Japan

[8] Int Univ Hlth & Welf Grad Sch, Fukuoka, Japan

[9] Fujita Hlth Univ, Sch Med, Aichi, Japan

[10] Ibaraki Christian Univ, Ibaraki, Japan

[11] Kyoto Univ, Grad Sch Med, Kyoto, Japan

[12] Kano Gen Hosp, Osaka, Japan

[13] Nakaya Clin, Tokyo, Japan

[14] Nakamura Gakuen Univ, Fukuoka, Japan

[15] Jichi Med Univ, Shimotsuke, Tochigi, Japan

[16] Saito Hosp, Sendai, Miyagi, Japan

来源：

ATHEROSCLEROSIS | 2008年 / 200卷 / 01期

关键词：

JELIS; eicosapentaenoic acid; primary prevention; coronary artery disease; risk factors; HDL-C; triglycerides;

D O I：

10.1016/j.atherosclerosis.2008.06.003

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: Japan EPA Lipid Intervention Study (JELIS) was a large-scale clinical trial examining the effects of eicosapentaenoic acid (EPA) on coronary artery disease (CAD) in hypercholesterolemic patients. Herein, we focused on risk factors other than low-density lipoprotein cholesterol (LDL-C) to investigate the effects of EPA on CAD among JELIS primary prevention cases. Methods: Hypercholesterolemic patients on statin therapy but without evidence of CAD (n=14,981) were randomly assigned to an EPA group (n=7503) or a control group (n=7478). The relationships between incident CAD, the number of CAD risk factors (hypercholesterolemia; obesity; high triglyceride (TG) or low high-density lipoprotein cholesterol (HDL-C); diabetes; and hypertension) and EPA treatment were investigated. Results: For the control and EPA groups combined, a higher number of risk factors was directly associated with an increased incidence of CAD. Incidence was lower for the EPA group than for the control group regardless of the numbers of risk factors. Compared to patients with normal serum TG and HDL-C levels, those with abnormal levels (TG >= 150 mg/dL; HDL-C < 40 mg/dL) had significantly higher CAD hazard ratio (HR: 1.71; 95% CI: 1.11-2.64; P=0.014). In this higher risk group, EPA treatment suppressed the risk of CAD by 53% (HR: 0.47; 95% Cl: 0.23-0.98; P=0.043). Conclusions: Multiple risk factors besides cholesterol are associated with markedly increased incidence of CAD. High TG with low HDL-C represents a particularly potent risk factor. EPA was effective in reducing the incidence of CAD events for patients with this dyslipidemic pattern, suggesting that EPA may be especially beneficial in patients who with abnormal TG and HDL-C levels (NCT00231738). (C) 2008 Elsevier Ireland Ltd. All rights reserved.

引用

页码：135 / 140

页数：6

共 30 条

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