Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp this study are consistent with the findings of the previous study. In terms of inflammatory markers, coronary sinus levels of pentraxin (PTX) 3 and monocyte chemoattractant protein (MCP)-1 were reduced by treatment with EPA. These 2 markers are known to be associated with the mechanism of many inflammatory diseases. In particular, the PTX3 level might reflect atherosclerotic activity, local inflammatory status, and plaque instability at the coronary culprit site more directly than other biomarkers. 7 In addition to the changes in plaque components, coronary vessel volumes were reduced in the EPA group more than in the control group, which also reflected the anti-inflammatory effect of EPA.Regarding the anti-inflammatory effects of EPA, Niki et al explain that its mechanisms were associated with prostaglandins, leukotrienes, nuclear factor κ-B, and peroxisome proliferator activated receptor γ . 3 PTX3 and MCP-1 levels were reduced in coronary sinus samples after EPA treatment, but not in femoral vein samples. These results suggest that EPA could improve the inflammation of coronary artery plaques. Recent studies have documented the efficacy of EPA in diseases other than coronary artery disease through improvement of inflammation. EPA prevented abdominal aortic aneurysm Beneficial Effects of EPA Statin monotherapy is widely prescribed to treat elevated levels of low-density lipoprotein (LDL) cholesterol and the beneficial effects on clinical outcomes in patients with cardiovascular diseases are recognized worldwide. However, patients have a residual risk despite highly effective statin therapy. A number of studies have been conducted over 10 years to explore the effects of adding other treatments to statins, called 'Beyond Statin', such as niacin, cholesteryl ester transfer protein inhibitors, ezetimibe, and eicosapentaenoic acid (EPA).
Article p 450The JELIS trial reported that EPA was a promising treatment for the prevention of major coronary events in Japanese hypercholesterolemic patients. 1 In that study, 18,645 patients (14,981 in primary prevention and 3,664 in secondary prevention) with hypercholesterolemia were randomly assigned to receive either 1,800 mg of EPA daily with a statin (EPA group; n=9,326) or a statin only (controls; n=9,319) with a 5-year follow-up. A 19% relative reduction in major coronary events was observed in the EPA group (P=0.011), and serum LDL cholesterol was not a significant factor in the reduction of risk for major coronary events. In the secondary prevention subgroup given EPA treatment, major coronary events were reduced by 19% (P=0.048). However, the JELIS trial did not include patients treated with strong statins.It has been reported that in the patients with coronary artery disease treated with a strong statin, the changes in destabilized components of coronary artery plaques evaluated by virtual histology intravascular ultrasound correlated negatively with the EPA to arachidoni...