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Journal Club
2007年4月26日 8：20～8：50
B棟8階 カンファレンス室
亀田メディカルセンター ジュニアレジデント
Junior resident,Kameda Medical Center
岡田 悠
Yu,Okada
Ｂａｃｋｇｒｏｕｎｄ
Epidemiological and clinical
evidence suggests that an
increased intake of long-chain n3 fatty acids protects against
mortality from coronary artery
disease.
Aim
long-term use of EPA is effective
for prevention of major coronary
events in hypercholesterolaemic
patients in Japan
Methods
【Patient】
5859 men (aged 40-75 years)
12786 posmenopausal woman
(aged up to75 years)
a total cholesterol of
6.5 mmol/L(250mg/dl) or greater
Methods
【The primary endpoint】
any major coronary event
【The secondary endpoint】
not reported
Methods
【Two subgroup】
With coronary artery disease
→3664 patients
Without
→14981 patients
Methods
【EPAgroup】
1800mg of EPA daily with statin
【Control】
statin only
(10mg of pravastatin or 5mg of simvastatin
For serious hypercholesterolaemia,
20mg of pravastatin or 10mg simvastatin)
Baseline characteristics
Age:61 years
Man:31%,Woman:69%
T.chol: 7.1 mmol/L (273.4mg/dl)
TG:1.7 mmol/L(151.3mg/dl)
LDL:4.7 mmol/L(183.3mg/dl)
HDL: 1.5 mmol/L(58.5mg/dl)
Baseline characteristics
Average dose:pravastatin 10.0mg daily
simvastatin 5.6mg daily
10mg pravastatin or 5mg simvastatin:90%
The maintenance of Study drug regimen
about 72%
【All patients】
Hazard ratio
P values
(95%CI)
EPA
Controls
【Primary prevention】
Hazard ratio
P values
(95%CI)
EPA
Controls
【Secondary prevention】
Hazard ratio
P values
(95%CI)
EPA
Controls
Hazard ratio
P values
(95%CI)
EPA
Controls
Interpretation
EPA is a promising treatment for
prevention of major coronary
events, and especially non-fatal
coronary events, in Japanese
hypercholesterolaemic patients.