- 著者
- Yasuhiro Nakano Mitsutaka Yamamoto Tetsuya Matoba Shunsuke Katsuki Soichi Nakashiro Susumu Takase Yusuke Akiyama Takuya Nagata Yasushi Mukai Shujiro Inoue Keiji Oi Taiki Higo Masao Takemoto Nobuhiro Suematsu Kenichi Eshima Kenji Miyata Makoto Usui Kenji Sadamatsu Toshiaki Kadokami Kiyoshi Hironaga Ikuyo Ichi Koji Todaka Junji Kishimoto Hiroyuki Tsutsui for the QcVIC Investigators
- 出版者
- Japan Atherosclerosis Society
- 雑誌
- Journal of Atherosclerosis and Thrombosis (ISSN:13403478)
- 巻号頁・発行日
- pp.63507, (Released:2022-12-01)
- 参考文献数
- 18
- 被引用文献数
- 4
Aim: Several clinical trials using intravascular ultrasound (IVUS) evaluation have demonstrated that intensive lipid-lowering therapy by statin or a combination therapy with statin and ezetimibe results in significant regression of coronary plaque volume. However, it remains unclear whether adding ezetimibe to statin therapy affects coronary plaque composition and the molecular mechanisms of plaque regression. We conducted this prospective IVUS analysis in a subgroup from the CuVIC trial. Methods: The CuVIC trial was a prospective randomized, open, blinded-endpoint trial conducted among 11 cardiovascular centers, where 260 patients with coronary artery disease who received coronary stenting were randomly allocated into either the statin group (S) or the combined statin and ezetimibe group (S+E). We enrolled 79 patients (S group, 39 patients; S+E group, 40 patients) in this substudy, for whom serial IVUS images of nonculprit lesion were available at both baseline and after 6-8 months of follow-up. Results: After the treatment period, the S+E group had significantly lower level of low-density lipoprotein cholesterol (LDL-C; 80.9±3.7 vs. 67.7±3.8 mg/dL, p=0.0143). Campesterol, a marker of cholesterol absorption, and oxysterols (β-epoxycholesterol, 4β-hydroxycholesterol, and 27-hydroxycholesterol) were also lower in the S +E group. IVUS analyses revealed greater plaque regression in the S+E group than in the S group (−6.14% vs. −1.18% for each group, p=0.042). It was noteworthy that the lowering of campesterol and 27-hydroxycholesterol, but not LDL-C, had a significant positive correlation with plaque regression. Conclusions: Compared with statin monotherapy, ezetimibe in combination with statin achieved significantly lower LDL-C, campesterol, and 27-hydroxycholesterol, which resulted in greater coronary plaque regression.
- 著者
- Kenji Momo Takeo Yasu Seiichiro Kuroda Sonoe Higashino Eiko Mitsugi Hiromasa Ishimaru Kazumi Goto Atsuko Eguchi Kuniyoshi Sato Masahiro Matsumoto Takashi Shiga Hideki Kobayashi Reisuke Seki Mikako Nakano Yoshiki Yashiro Takuya Nagata Hiroshi Yamazaki Shou Ishida Naoki Watanabe Mihoko Tagomori Noboru Sotoishi Daisuke Sato Kengo Kuroda Dai Harada Hitoshi Nagasawa Takashi Kawakubo Yuta Miyazawa Kyoko Aoyagi Sachiko Kanauchi Kiyoshi Okuyama Satoshi Kohsaka Kohtaro Ono Yoshiyasu Terayama Hiroshi Matsuzawa Mikio Shirota
- 出版者
- The Pharmaceutical Society of Japan
- 雑誌
- Biological and Pharmaceutical Bulletin (ISSN:09186158)
- 巻号頁・発行日
- vol.45, no.10, pp.1489-1494, 2022-10-01 (Released:2022-10-01)
- 参考文献数
- 19
- 被引用文献数
- 1
The aim of this study was to determine the proportion of near-miss dispensing errors in hospital pharmacies in Japan. A prospective multi-center observational study was conducted between December 2018 and March 2019. The primary objective was to determine the proportion of near-miss dispensing errors in hospital pharmacy departments. The secondary objective was to determine the predictive factors for near-miss dispensing errors using multiple logistic regression analysis. The study was approved by the ethical committee at The Institute of Medical Sciences, University of Tokyo, Japan. A multi-center prospective observational study was conducted in 20 hospitals comprising 8862 beds. Across the 20 hospitals, we assessed data from 553 pharmacists and 53039 prescriptions. A near-miss dispensing error proportion of 0.87% (n = 461) was observed in the study. We found predictive factors for dispensing errors in day-time shifts: a higher number of drugs in a prescription, higher number of quantified drugs, such as liquid or powder formula, in a prescription, and higher number of topical agents in a prescription; but we did not observe for career experience level for clinical pharmacists. For night-time and weekend shifts, we observed a negative correlation of near-miss dispensing errors with clinical pharmacist experience level. We found an overall incidence of near-miss dispensing errors of 0.87%. Predictive factors for errors in night-time and weekend shifts was inexperienced pharmacists. We recommended that pharmacy managers should consider education or improved work flow to avoid near-miss dispensing errors by younger pharmacists, especially those working night or weekend shifts.