著者

Atsuhito Saiki Yasuhiro Watanabe Takashi Yamaguchi Masahiro Ohira Daiji Nagayama Naoko Sato Mizuho Kanayama Mao Takahashi Kazuhiro Shimizu Masao Moroi Yoh Miyashita Kohji Shirai Ichiro Tatsuno

出版者

Japan Atherosclerosis Society

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

vol.28, no.10, pp.1083-1094, 2021-10-01 (Released:2021-10-01)

参考文献数

32

被引用文献数

7

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Aim: In the TOHO Lipid Intervention Trial Using Pitavastatin (TOHO-LIP), a multicenter randomized controlled trial, pitavastatin significantly reduced cardiovascular (CV) events compared to atorvastatin in patients with hypercholesterolemia. To investigate the mechanism by which pitavastatin preferentially prevents CV events, we investigated the relationship between CV events and cardio-ankle vascular index (CAVI) using the TOHO-LIP database. Methods: For the subgroup analysis, we selected patients from a single center, Toho University Sakura Medical Center. After excluding those who had CV events at baseline or during the first year, 254 patients were enrolled. The primary end point was the same as that of TOHO-LIP, and three-point major cardiac adverse events (3P-MACE) was added as secondary end point. Results: The cumulative 5-year incidence of 3P-MACE (pitavastatin 1.6%, atorvastatin 6.1%, P=0.038) was significantly lower in pitavastatin group (2 mg/day) than in atorvastatin group (10 mg/day). CAVI significantly decreased only in pitavastatin group during the first year (9.50–9.34, P=0.042), while the change in low-density lipoprotein cholesterol (LDL-C) did not differ between the two groups. The change in CAVI during the first year positively correlated with 3P-MACE and tended to be an independent predictor of 3P-MACE in Cox proportional hazards model (hazard ratio, 1.736; P=0.079). The annual change in CAVI throughout the observation period was significantly higher in subjects with CV events compared to those without. Conclusions: In this subgroup analysis, the reduction in CV events tended to be associated with the CAVI-lowering effect of pitavastatin, which was independent of the LDL-C-lowering effect.

著者

Tomoyuki Yamamoto Kazuhiro Shimizu Mao Takahashi Ichiro Tatsuno kohji Shirai

出版者

一般社団法人 日本動脈硬化学会

雑誌

Journal of Atherosclerosis and Thrombosis (ISSN:13403478)

巻号頁・発行日

pp.38646, (Released:2017-03-22)

参考文献数

32

被引用文献数

16

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Aim: The effect of nitroglycerin on proper arterial stiffness of the arterial tree has not been fully clarified. The cardio-ankle vascular index (CAVI), which is an application of the stiffness parameter β theory on the arterial tree from the origin of the aorta to the ankle, was developed recently. Furthermore, the stiffness of the aorta (heart-thigh β (htBeta)) and of the femoral-tibial arteries (thigh to ankle β (taBeta)) could be monitored by applying the same theory. The effects of nitroglycerin on CAVI, htBeta, and taBeta were studied comparing the values of healthy people and those of arteriosclerotic patients.Methods: The subjects were healthy people (CAVI <7.5, n=25) and arteriosclerotic patients (CAVI >9, n=25). Nitroglycerin (0.3 mg) was administrated sublingually, and various arterial stiffness indices were measured at one-minute intervals for a period of 20 minutes using Vasera VS-1500 (Fukuda Denshi, Tokyo).Results: After the administration of nitroglycerin in healthy people, CAVI decreased significantly after 5 min. [from 6.76(6.32-7.27) to 5.50(4.70-6.21), P<0.05], and recovered after 15 min. htBeta [from 5.10(4.76-5.76) to 3.96(3.35-4.79), P<0.05], and taBeta [from 14.41(10.80-16.33) to 10.72 (9.19-13.01), P<0.05] also decreased significantly. In arteriosclerotic patients, CAVI decreased after 5 min. [from 10.47(9.67-11.29) to 9.71(8.74-10.57), P<0.05] and recovered after 15 min. htBeta did not significantly change [from 12.00(11.46-13.21) to 11.81(10.14-13.83), ns], but taBeta decreased significantly [from 18.55(12.93-23.42) to 12.37(9.68-16.99), P<0.05].Conclusion: These results indicate that a nitroglycerin-induced decrease of arterial stiffness is more prominent in muscular arteries than in elastic arteries, and this effect was preserved much more prominently in arteriosclerotic patients than in healthy people.