Effect of Long-Term Intensive Lipid-Lowering Therapy With Rosuvastatin on Progression of Carotid Intima-Media Thickness – Justification for Atherosclerosis Regression Treatment (JART) Extension Study –

Ryuji Nohara; Hiroyuki Daida; Mitsumasa Hata; Kohei Kaku; Ryuzo Kawamori; Junji Kishimoto; Masahiko Kurabayashi; Izuru Masuda; Ichiro Sakuma; Tsutomu Yamazaki; Hiroyoshi Yokoi; Masayuki Yoshida; for the Justification for Atherosclerosis Regression Treatment (JART) Investigators

doi:10.1253/circj.CJ-12-1149

Metabolic Disorder

Effect of Long-Term Intensive Lipid-Lowering Therapy With Rosuvastatin on Progression of Carotid Intima-Media Thickness

– Justification for Atherosclerosis Regression Treatment (JART) Extension Study –

Ryuji Nohara, Hiroyuki Daida, Mitsumasa Hata, Kohei Kaku, Ryuzo Kawamori, Junji Kishimoto, Masahiko Kurabayashi, Izuru Masuda, Ichiro Sakuma, Tsutomu Yamazaki, Hiroyoshi Yokoi, Masayuki Yoshida, for the Justification for Atherosclerosis Regression Treatment (JART) Investigators

Author information

Ryuji Nohara
Cardiovascular Center, Kitano Hospital, The Tazuke Kofukai Medical Research Institute
Hiroyuki Daida
Department of Cardiology, Juntendo University School of Medicine
Mitsumasa Hata
Department of Cardiovascular Surgery, Nihon University School of Medicine
Kohei Kaku
Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, Kawasaki Medical School
Ryuzo Kawamori
Sportology Center, Juntendo University Graduate School of Medicine, supported by High Technology Research Center Grant from the Ministry of Education, Culture, Sports, Science and Technology of Japan
Junji Kishimoto
Center for Clinical and Translational Research, Kyushu University Hospital
Masahiko Kurabayashi
Department of Medicine and Biological Science, Gunma University Graduate School of Medicine
Izuru Masuda
Takeda Hospital Medical Examination Center
Ichiro Sakuma
Hokko Memorial Clinic Caress Sapporo
Tsutomu Yamazaki
Clinical Research Support Center, The University of Tokyo Hospital
Hiroyoshi Yokoi
Department of Cardiology, Kokura Memorial Hospital
Masayuki Yoshida
Department of Life Sciences and Bioethics, Graduate School of Medicine, Tokyo Medical and Dental University
for the Justification for Atherosclerosis Regression Treatment (JART) Investigators

Keywords: Carotid intima-media thickness, Clinical trial, Dyslipidemia, Hydroxymethylglutaryl-CoA reductase inhibitors, Rosuvastatin

JOURNAL FREE ACCESS

2013 Volume 77 Issue 6 Pages 1526-1533

DOI https://doi.org/10.1253/circj.CJ-12-1149

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Abstract

Background: Recently, it was reported from the Justification for Atherosclerosis Regression Treatment (JART) Study that intensive therapy with rosuvastatin significantly slowed progression of carotid intima-media thickness (IMT) compared with conventional therapy with pravastatin at 12 months. To assess the long-term efficacy of intensive therapy, the present extension study was conducted. Methods and Results: Subjects in the intensive therapy group of the JART Study were asked to participate in the extension study and to continue rosuvastatin treatment. A total of 113 subjects were enrolled into the extension study and were included in the analysis. At 24 months, the mean daily dose of rosuvastatin (±SD) was 7.9±2.9mg. Mean change in mean IMT was –0.005mm (range, –0.024 to 0.015mm) at 24 months (P=0.633, compared with baseline). Rosuvastatin lowered low-density lipoprotein cholesterol (mean±SD) by 46.4±13.8% and elevated high-density lipoprotein cholesterol (mean±SD) by 8.9±24.0% at 24 months compared with baseline. Gray scale median was measured in 25 subjects. It increased by 16.93±33.12 (mean±SD) % at 12 months and by 22.50±52.83% at 24 months from baseline (P=0.017, P=0.044, respectively). Conclusions: Two-year treatment with rosuvastatin inhibited progression of carotid IMT. Rosuvastatin also improved the plaque composition, and this qualitative change occurred relatively early after starting therapy. (Circ J 2013; 77: 1526–1533)

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