- 著者
 
          - 
             
             Saurabh P. Nagar
             
             Pratik P. Rane
             
             Kathleen M. Fox
             
             Juliana Meyers
             
             Keith Davis
             
             Anne Beaubrun
             
             Hyoe Inomata
             
             Yi Qian
             
             Kouji Kajinami
             
          
 
          
          
          - 出版者
 
          - The Japanese Circulation Society
 
          
          
          - 雑誌
 
          - Circulation Journal (ISSN:13469843)
 
          
          
          - 巻号頁・発行日
 
          - vol.82, no.4, pp.1008-1016, 2018-03-23 (Released:2018-03-23)
 
          
          
          - 参考文献数
 
          - 29
 
          
          
          - 被引用文献数
 
          - 
             
             
             23
             
             
          
        
 
        
        
        Background:This study examined treatment patterns, possible statin intolerance, and incidence of cardiovascular events (CVEs) in 2 cohorts of patients with high cardiovascular risk (i.e., patients with atherosclerotic cardiovascular disease [ASCVD] and patients with diabetes mellitus).Methods and Results:A retrospective cohort study examined adults initiating either a statin or ezetimibe from 1 January 2006 to 31 May 2014 in the Japan Medical Data Center database. The first observed statin or ezetimibe prescription defined the index date. Patients had ≥12 months of pre- and post-index date plan enrollment. Two high-risk cohorts, the ASCVD cohort and diabetes cohort, were created based on diagnoses observed during the 12 months’ pre-index date. Treatment patterns, possible statin intolerance, and incidence of CVEs were reported. In the ASCVD cohort (n=5,302), 32.9% discontinued therapy, 7.7% switched to a non-index statin or non-statin lipid-lowering therapy, and 11.2% augmented index therapy in the 12 months’ post-index date; only 0.3% were using high-intensity statins and 10% had possible statin intolerance. Also, 8.1% had any new CVE during the follow-up period. Treatment patterns and incidence of CVEs among the diabetes cohort were similar to those of the ASCVD cohort.Conclusions:High cardiovascular risk Japanese patients had frequent treatment modifications, although use of high-intensity statin doses was rare. These patterns may indicate that alternative therapies for lipid lowering are needed.