所属 医学部 医学科（東京女子医科大学病院） 職種 准教授
|発表タイトル||Effect of Combination Theraphy With Ezetimibe And Pitavastatin On Cardiovascular Outcomes in Patients With And Without Hypertension: Findings Of The HIJ-Proper Trial|
|会議名||American Heart Association (AHA) Scientific Sessions 2018|
|主催者||American Heart Association (AHA)|
|発表者・共同発表者||◎SEKIGUCHI Haruki, SUZUKI Keisuke, IM Jihaeng, OGISO Masataka, WATANABE Erisa, ARASHI Hiroyuki, YAMAGUCHI Junichi, OGAWA Hiroshi, HAGIWARA Nobuhisa|
|学会抄録||Circulation 138(Suppl 1),Abstract 11346 2018|
|概要||*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.