Rationale and design of a randomized clinical study to investigate the effect of ezetimibe, a cholesterol absorption inhibitor, on the regression of intracoronary plaque evaluated by non-obstructive angioscopy and ultrasound: The ZIPANGU study

Hiro, Takafumi; Hirayama, Atsushi; Ueda, Yasunori; Komatsu, Sei; Matsuoka, Hiroshi; Takayama, Tadateru; Ishihara, Masaharu; Hayashi, Takatoshi; Saito, Satoshi

doi:10.1016/j.jjcc.2014.02.026

Cited by 8 publications

(5 citation statements)

References 47 publications

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“…Intensive reductions in the LDL-C levels achieved with statins not only improve lipid profiles, but also significantly prevent the incidence of major cardiovascular events compared to conventional lipid-lowering treatment for high-risk patients [4,5]. Therefore, intensive lipidlowering therapy slows the progression and/or induces the regression of atherosclerosis, which may result in a reduction in the frequency of cardiovascular events [6][7][8][9]. However, a large number of cardiovascular events continued to occur due to residual risks even though the usual treatment with statins has achieved substantial reductions in LDL-C.…”

Section: Introductionmentioning

confidence: 99%

High-dose statin therapy with rosuvastatin reduces small dense LDL and MDA-LDL: The Standard versus high-dose therApy with Rosuvastatin for lipiD lowering (SARD) trial

Nishikido

Oyama

Keida

et al. 2016

Journal of Cardiology

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Section: Introductionmentioning

confidence: 99%

High-dose statin therapy with rosuvastatin reduces small dense LDL and MDA-LDL: The Standard versus high-dose therApy with Rosuvastatin for lipiD lowering (SARD) trial

Nishikido

Oyama

Keida

et al. 2016

Journal of Cardiology

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“…The details of the study design, including the sample size determination, were previously reported. 5 The study was registered in the UMIN Clinical Trial Registry (UMIN000006971). Written informed consent was given by all enrolled patients.…”

Section: Methodsmentioning

confidence: 99%

Effect of Ezetimibe on Stabilization and Regression of Intracoronary Plaque　― The ZIPANGU Study ―

Ueda

Hiro

Hirayama

et al. 2017

Circ J

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(IVUS), respectively, in the TWINS 3 and TOGETHAR 4 studies.In the present ZIPANGU (ezetimibe clinical investigation for regression of intracoronary plaque evaluated by angioscopy and ultrasound) study, we compared the effect of combination therapy (statin+ezetimibe) and monotherapy (statin alone) through examination of the plaque stabilization effect by angioscopy and the plaque regression effect by IVUS. Methods Study DesignThis study was a multicenter, prospective, randomized, L ow-density lipoprotein cholesterol (LDL-C)-lowering therapy has been shown to be effective for primary and secondary prevention of cerebrovascular and cardiovascular diseases. Ezetimibe, an inhibitor of the Niemann-Pick C1-like 1 cholesterol transporter, is a relatively new drug for LDL-C-lowering therapy. 1 Combination therapy with a statin and ezetimibe produced better clinical outcomes than statin monotherapy in the IMPROVE-IT (Improved Reduction of Outcomes; Vytorin Efficacy International Trial) study. 2 However, the plaque stabilization and regression effects of these 2 therapies have not been adequately evaluated. We previously investigated the plaque stabilization effect and plaque regression effect of statin therapies by angioscopy and intravascular ultrasound Background: Diminishing yellow color is associated with plaque stabilization. We assessed the hypothesis that a combination of ezetimibe and statin provides more effective plaque stabilization and regression than statin alone as assessed by plaque color.

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“…Recent evidence suggests that a sharp decline in the levels of LDL-C that is obtained with statins not only increases lipid profiles improvement but also significantly prevented the incidence of cardiovascular events compared to conventional lipid-lowering treatments for high-risk patients 5 .This finding is supported by many scientists working on patients who were treated with a statin 6 , 7 . Therefore, treatments with severe lipid reduction provide further clinical benefit and accelerate the improvement of atherosclerosis, which may lead to a decrease in cardiovascular events 8 , 9 . However, the risk remains among statin-treated individuals and is known as "remaining risk" 10 .…”

Section: Introductionmentioning

confidence: 99%

Evaluation of LDL goal achievement in statin consumption, south east of Iran

Aghasizadeh

Bizhaem

Baniasadi

et al. 2021

Sci Rep

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Lipid goal achievement and statin consumption were estimated at extreme/very-high/high/moderate and low cardiovascular risk categories. In the cross-sectional study, 585 patients treated with statin therapy referring to the heart clinic of Birjand were recruited. Patients were classified and examined LDL-C values and the proportion reaching targets according to the American Association of Clinical Endocrinologists guideline. Three patterns of statin use (high/moderate/low-intensity statin therapy) in all patients were examined and attainments of LDL-C goal in cardiovascular risk groups have been demonstrated. Over half the populations (57.6%) were in the very-high CVD risk group. The results showed that the proportion of patients meeting total LDL-C goal values according to the guidelines was 43.4%. The frequency of patient had achievement LDL goal lower in high-intensity pattern (N = 13, 2.3%), compared with moderate (N = 496, 86.1%) and low-intensity patterns (N = 67, 11.6%). In general, LDL-C goal achievement was greatest with moderate-intensity statin use. LDL-C reduction after statin consumption was estimated about one-third of the studied population. It seems likely that the achievement of a therapeutic target for serum lipids such as LDL-C improved is far more cost-effective and would be able to reach the target LDL as well changing the type and intensity of statins.

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Rationale and design of a randomized clinical study to investigate the effect of ezetimibe, a cholesterol absorption inhibitor, on the regression of intracoronary plaque evaluated by non-obstructive angioscopy and ultrasound: The ZIPANGU study

Abstract: The ZIPANGU study will clarify whether combination therapy with statins and ezetimibe is better for stabilizing coronary plaque as secondary prevention than monotherapy by statins alone. The study will give new insights into lipid-lowering guidelines in Japan.

Cited by 8 publications

References 47 publications

High-dose statin therapy with rosuvastatin reduces small dense LDL and MDA-LDL: The Standard versus high-dose therApy with Rosuvastatin for lipiD lowering (SARD) trial

High-dose statin therapy with rosuvastatin reduces small dense LDL and MDA-LDL: The Standard versus high-dose therApy with Rosuvastatin for lipiD lowering (SARD) trial

Effect of Ezetimibe on Stabilization and Regression of Intracoronary Plaque　― The ZIPANGU Study ―

Evaluation of LDL goal achievement in statin consumption, south east of Iran

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Rationale and design of a randomized clinical study to investigate the effect of ezetimibe, a cholesterol absorption inhibitor, on the regression of intracoronary plaque evaluated by non-obstructive angioscopy and ultrasound: The ZIPANGU study

Abstract: The ZIPANGU study will clarify whether combination therapy with statins and ezetimibe is better for stabilizing coronary plaque as secondary prevention than monotherapy by statins alone. The study will give new insights into lipid-lowering guidelines in Japan.

Cited by 8 publications

References 47 publications

High-dose statin therapy with rosuvastatin reduces small dense LDL and MDA-LDL: The Standard versus high-dose therApy with Rosuvastatin for lipiD lowering (SARD) trial

High-dose statin therapy with rosuvastatin reduces small dense LDL and MDA-LDL: The Standard versus high-dose therApy with Rosuvastatin for lipiD lowering (SARD) trial

Effect of Ezetimibe on Stabilization and Regression of Intracoronary Plaque ― The ZIPANGU Study ―

Evaluation of LDL goal achievement in statin consumption, south east of Iran

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Effect of Ezetimibe on Stabilization and Regression of Intracoronary Plaque　― The ZIPANGU Study ―