Effects of Pravastatin on Exercise Electrocardiography Test Performance and Cardiovascular Mortality and Morbidity in Patients With Hypercholesterolemia

Sasaki, Susumu; Nakagawa, Masao; Nakata, Tetsuo; Azuma, Akihiro; Sawada, Shohei; Takeda, Kazuo; Asayama, Jun

doi:10.1253/circj.66.47

Cited by 10 publications

(6 citation statements)

References 17 publications

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“…In contrast to our results, Sasaki et al [8] reported that pravastatin did not improve exercise ECG findings. These authors hypothesized that quantitative changes in coronary atheromatous plaques, i.e.…”

Section: Discussioncontrasting

confidence: 99%

“…Pravastatin, one of the 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors, potently reduces serum cholesterol levels and inhibits coronary events [3,8,11,12,17]. In the present study, total cholesterol and LDL-cholesterol levels at the end of the study were lower in the pravastatin group than in the normal diet group.…”

Section: Discussionmentioning

confidence: 44%

“…In addition, angina pectoris may be misdiagnosed when it is predominantly based on the patient's symptoms. In such cases, there are very few reports of patient evaluation based on objective data, such as ECG changes [8,13,14].…”

Section: Introductionmentioning

confidence: 99%

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Electrocardiographic events and cholesterol reduction with pravastatin in patients with hypercholesterolemia: the Hokuriku Lipid Coronary Heart Disease Study-Pravastatin Atherosclerosis Trial

Shimizu

Koizumi

Miyamoto³

et al. 2005

International Journal of Cardiology

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 44%

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Electrocardiographic events and cholesterol reduction with pravastatin in patients with hypercholesterolemia: the Hokuriku Lipid Coronary Heart Disease Study-Pravastatin Atherosclerosis Trial

Shimizu

Koizumi

Miyamoto³

et al. 2005

International Journal of Cardiology

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“…Eighteen RCTs were included and appraised after ruling out (1) the interventions or outcomes not of interest and (2) non-RCTs. Among the included studies, 18 trials were with coronary event analysis (N = 103,864); 15 trials, total mortality event analysis (N = 93,215); 16 trials, lipid-lowering drug (11 statin trials [16][17][18][19][20][21][22][23][24][25][26], 1 cholestyramine resin trial [18,27], 1 fibrate trial [28], 1 gemfibrozil trial [29], 1 combination therapy trial [30]) vs. placebo; two trials, lipid-lowering drug vs. usual care (statin trials [31,32]; usual care was defined as medical care with nutrition education and lipid-lowering medication prescribed by health care providers); and 1 trial, absolute LDL-C level (a statin trial [33]). The characteristics of each trial are provided in Table 1.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of more intensive lipid-lowering therapy on cardiovascular diseases: a systematic review and meta-analysis

Hsu

Lin

Lee

et al. 2020

BMC Cardiovasc Disord

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Background: Cardiovascular disease is the leading cause of morbidity and mortality with incidence rates of 5-10 per 1000 person-years, according to primary prevention studies. To control hyperlipidemia-a major risk factor of cardiovascular disease-initiation of lipid-lowering therapy with therapeutic lifestyle modification or lipid-lowering agent is recommended. Few systematic reviews and meta-analyses are available on lipid-lowering therapy for the primary prevention of cardiovascular diseases. In addition, the operational definitions of intensive lipid-lowering therapies are heterogeneous. The aim of our study was to investigate whether intensive lipid-lowering therapies reduce greater cardiovascular disease risks in primary prevention settings. Methods: MEDLINE, EMBASE, and Cochrane Library databases were searched from inception to March 2019 for randomized controlled trials. We used random effects model for overall pooled risk ratio (RR) estimation with cardiovascular events of interest and all-cause mortality rate for the intensive lipid-lowering group using the standard lipid-lowering group as the reference. The Cochrane Risk of Bias Tool was used for quality assessment. Results: A total of 18 randomized controlled trials were included. The risk reductions in cardiovascular outcomes and all-cause mortality associated with more intensive vs. standard lipid-lowering therapy across all trials were 24 and 10%, respectively (RR 0.76, 95% confidence interval 0.68-0.85; RR 0.90, 95% confidence interval 0.83-0.97); however, the risk reduction varied by baseline LDL-C level in the trial. A greater risk reduction was noted with higher LDL-C level. Intensive lipid-lowering for coronary heart disease protection was more pronounced in the nondiabetic populations than in the diabetic populations. Conclusions: More intensive LDL-C lowering was associated with a greater reduction in risk of total and cardiovascular mortality in trials of patients with higher baseline LDL-C levels than less intensive LDL-C lowering. Intensive lipid-lowering was associated with a significant risk reduction of coronary heart disease and must be considered even in the non-diabetic populations.

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“…Soft plaques containing large amounts of lipid and thin fibrin cap are vulnerable to rupture, resulting in acute coronary syndrome. 5,6 Thus, CT imaging information facilitates design of tailor-made therapy (eg, aggressive lipid lowering therapy, [23][24][25] antiplatelet therapy) to prevent plaque rupture. Second, 16slice CT information is useful for planning of percutaneous coronary intervention (PCI).…”

Section: Discussionmentioning

confidence: 99%

Noninvasive Tissue Characterization of Coronary Arterial Plaque by 16-Slice Computed Tomography in Acute Coronary Syndrome

et al. 2006

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Noninvasive characterization of coronary plaques is challenging for cardiologists. The authors' goal was to explore the clinical feasibility of newly developed 16-slice computed tomography (CT) in tissue characterization of coronary arterial plaques in patients with acute coronary syndrome. Sixteen patients with acute coronary syndrome underwent 16-slice CT (Aquillion, Toshiba) and coronary arteriography with intravascular ultrasound (IVUS) within 7 days. Twenty-three plaques were classified by IVUS according to plaque echogenicity: 6 soft plaques, 11 intermediate plaques, and 6 calcified plaques. Mean (+/- SD) CT numbers (Hounsfield units [HU]) of these 3 types of plaques were 50.6 +/-14.8 HU, 131 +/-21.0 HU, and 721 +/-231 HU, respectively. Sixteen-slice CT facilitates noninvasive tissue characterization of coronary arterial plaques.

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Effects of Pravastatin on Exercise Electrocardiography Test Performance and Cardiovascular Mortality and Morbidity in Patients With Hypercholesterolemia

Cited by 10 publications

References 17 publications

Electrocardiographic events and cholesterol reduction with pravastatin in patients with hypercholesterolemia: the Hokuriku Lipid Coronary Heart Disease Study-Pravastatin Atherosclerosis Trial

Electrocardiographic events and cholesterol reduction with pravastatin in patients with hypercholesterolemia: the Hokuriku Lipid Coronary Heart Disease Study-Pravastatin Atherosclerosis Trial

Efficacy of more intensive lipid-lowering therapy on cardiovascular diseases: a systematic review and meta-analysis

Noninvasive Tissue Characterization of Coronary Arterial Plaque by 16-Slice Computed Tomography in Acute Coronary Syndrome

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