ARASHI Hiroyuki
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Assistant Professor
Language English
Title Effect of Combination Theraphy With Ezetimibe And Pitavastatin On Cardiovascular Outcomes in Patients With And Without Hypertension: Findings Of The HIJ-Proper Trial
Conference American Heart Association (AHA) Scientific Sessions 2018
Promoters American Heart Association (AHA)
Conference Type International society and overseas society
Presentation Type Poster notice
Lecture Type General
Publisher and common publisher◎SEKIGUCHI Haruki, SUZUKI Keisuke, IM Jihaeng, OGISO Masataka, WATANABE Erisa, ARASHI Hiroyuki, YAMAGUCHI Junichi, OGAWA Hiroshi, HAGIWARA Nobuhisa
Date 2018/11/10
Venue
(city and name of the country)
Chicago, USA
Society abstract Circulation 138(Suppl 1),Abstract 11346 2018
Summary *Session Type: Pharmacotherapy in ACS and Stable Ischemic Heart Disease

Introduction: Lipid-lowering therapy is used for secondary prevention in patients with coronary artery disease, especially those with a history of acute coronary syndrome (ACS). Hypertension (HTN) is a classic coronary risk factor in ACS patients. However, it remains unclear which coronary risk factors can predict adverse events in patients with ACS undergoing aggressive lipid-lowering management, according to the presence or absence of HTN.

Hypothesis: We aimed to identify predictors of major adverse cardiac events (MACEs) in ACS patients with dyslipidaemia undergoing aggressive lipid-lowering therapy, according to the presence or absence of HTN.

Methods: This was a sub-analysis of the HIJ-PROPER study. We performed Kaplan-Meier analysis and multivariate Cox regression analysis of MACEs using coronary risk factors including, ageing, sex, diabetes mellitus (DM), impaired renal function, prior myocardial infarction (MI), smoking history, and treatment group.

Results: In HTN patients, Cox regression analysis showed that ageing (hazard ratio [HR] 1.01, p<0.05), DM (HR 1.33, p<0.01), and smoking history (HR1.34, p<0.01) were independent predictors. In non-HTN patients, ageing (HR1.03, p<0.001), DM (HR1.63, p<0.01), smoking history (HR1.42, p<0.05) and prior MI (HR2.15, p<0.01) were independent predictors. Only the combined use of pitavastatin and ezetimibe (HR0.63, p<0.01) reduced risk of MACEs (Table1). Kaplan-Meier analysis revealed that the combined treatment with pitavastatin and ezetimibe resulted in a lower incidence rate of MACEs than pitavastatin mono-treatment in the only non-HTN patients, but not in the HTN patients (Figure 1).

Conclusions: Our results suggest that risk factors differed between ACS patents with and without HTN. Moreover, combined treatment with pitavastatin and ezetimibe may be beneficial in ACS patients without HTN for secondary prevention.