Volume 32,
Issue 12,
2011
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Symposium
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第75回日本循環器学会総会・学術集会ランチョンセミナー
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Source:
Therapeutic Research 32巻12号, 1561-1567 (2011);
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第4回アジア太平洋不整脈学会学術集会第26回日本不整脈学会学術大会第28回日本心電学会学術集会合同学術集会ランチョンセミナー
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Source:
Therapeutic Research 32巻12号, 1573-1582 (2011);
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原著
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Source:
Therapeutic Research 32巻12号, 1587-1603 (2011);
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Source:
Therapeutic Research 32巻12号, 1605-1610 (2011);
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Source:
Therapeutic Research 32巻12号, 1611-1615 (2011);
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The current first-line anti-cholesterolemic therapy is HMG-CoA reductase inhibitors (statins). Statins have pleiotropic effects such as inhibiting inflammation, reducing oxidative activity, and improving endothelial function. Dehydroepiandrosterone sulfate(DHEA-S)is an adrenal androgen with various physiological effects on atherosclerosis, obesity, diabetes, cancer, osteoporosis, and immune regulation. Statins may also suppress the production of steroid hormones (glucocorticoids, mineralocorticoids, and adrenal androgens) after decreasing cholesterol levels. Rosuvastatin is a powerful statin with higher potency for lowering LDL-cholesterol compared to other statins. In this study, we examined the effects of rosuvastatin on cholesterol levels and DHEA-S activity following administration for 6 months in 42 patients with hypercholesterolemia(17men and 25 women, mean age:59.5±13.0 yr, mean±SD). The patients’serum lipid profiles (total cholesterol, triglyceride, HDL-C, and LDL-C) improved significantly and serum DHEA-S increased significantly after rosuvastatin treatment. We conclude that rosuvastatin is an effective drug for improving serum lipid profiles and increasing serum levels of DHEA-S.
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Source:
Therapeutic Research 32巻12号, 1617-1627 (2011);
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目的:HMG-CoA 還元酵素阻害薬(スタチン)の使用に関する実態調査は,全国でも過去行われてきている。福島県郡山地区における日常診療でのスタチン投与患者の脂質値を調査することで,脂質管理の現状を再評価する。方法:2010 年 6 月~2010 年 12 月の 6 ヵ月間で,郡山地区の医療機関に外来通院している高コレステロール血症患者を 1 医師あたり 25症例,500 例を目標として連続調査方式で登録し,年齢や性別,危険因子などの患者背景,使用薬剤,投与量,脂質値,肝機能,腎機能を調査した。結果:投与 12 週後の脂質値は総コレステロール(TC),LDL コレステロール(LDL-C),HDLコレステロール(HDL-C),LDL-C/HDL-C 比,non-HDL-C で投与開始時と比べて有意に低下していた(p<0.001)。主要評価項目である投与12 週後のスタチン別 LDL-C ガイドライン管理目標値到達率は,全症例平均で 84.2%,カテゴリー I が 91.7%,I I が 91.3%,I I I が 81.2%,二次予防で 73.2%,薬剤別ではカテゴリー I,I I,二次予防では差がみられなかったが,カテゴリーI I I ではストロングスタチン 3 剤がプラバスタチンと比べて有意に LDL-C 管理目標値到達率が高かった(p<0.05 vs. ピタバスタチン,p<0.001vs. アトルバスタチン,ロスバスタチン)。LDLC/HDL-C 比 2.0 未満到達率は 63.1%で薬剤間に差はなく,1.5 未満到達率は 33.8%でロスバスタチンがプラバスタチンと比べて有意に到達率が高かった(p<0.05)。LDL-C/HDL-C 比 2.0未満,1.5 未満到達率はストロングスタチンのほうがレギュラースタチンより有意に高かった(p<0.05)。結語:レギュラースタチンと比べてストロングスタチンを使用している群において,高いLDL-C 管理目標値到達率が得られ,LDL-C/HDL-C 比 2.0 未満,1.5 未満到達率も有意に高かった。
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Source:
Therapeutic Research 32巻12号, 1629-1636 (2011);
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Source:
Therapeutic Research 32巻12号, 1637-1644 (2011);
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Source:
Therapeutic Research 32巻12号, 1645-1651 (2011);
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Objective:The aim of this study is to evaluate the efficacy of rosuvastatin 2.5 mg/day and atrovastatin 10 mg/day on serum lipid parameters in patients with dyslipidemia who have more than middle risk for the primary prevention. We also evaluate the renal safety of these potent statins. Methods:We collected clinical data from patients with dyslipidemia who categorized the risk category I I and I I I of the Japan Atherosclerosis Society Guideline and prescribed rosuvastatin 2.5 mg/day or atrovastatin 10 mg/day for more than eight weeks. We evaluated changes of lipid parameters before and after the treatment, and compared them between two treatment groups. We estimated the proportion of achieving LDL cholesterol(LDL-C)management goal for each risk category. We also evaluated parameters of renal function. Results:Total 77 patients enrolled into the study. LDL-C significantly decreased by 46.3% in rosuvastatin group(RSV)and by 43.3% in atorvastatin group(ATV)(p<0.05, respectively). HDL cholesterol(HDL-C)increased by 5.2% in RSV and by 5.6% in ATV. Triglyceride decreased by 2.2% in RSV(not significant)and by 20.8% in ATV(p<0.05). There were no significant differences in changes of all lipid parameters between two groups. The proportions of achieving LDL-C goal in category I I I were 100% in RSV and 76.9% in ATV. Changes of parameters of renal function were not significantly in both groups. Conclusions:In patients with dyslipidemia who have more than middle risk for the primary prevention, RSV was shown to be equivalent to or more effective than ATV and be safe with no effect on renal function.
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Source:
Therapeutic Research 32巻12号, 1653-1661 (2011);
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Objective:This study aimed to evaluate efficacy and safety of three potent statins in patients with hypercholesterolemia who were newly prescribed statins. We also evaluate efficacy and safety of rosuvastatin 5 mg/day in patients who did not achieve LDL cholesterol (LDL-C)management goal of the Japan Atherosclerosis Society Guideline with rosuvastatin 2.5 mg/day. Methods:In the first study, patients with hypercholesterolemia who never treated with lipid-lowering agents were randomly assigned to atrovastatin 10 mg/day, pitavastatin 2 mg/day or rosuvastatin 2.5 mg/day and treated for at least 3 months. We evaluated changes of parameters on lipid(LDL-C, LDL-C/HDL-C, HDL-C and TG)and safety(AST, ALT, γ-GTP, CK, eGFR and HbA1c)before and after the treatment, and compared them among three treatment groups. In the second study, patients with hypercholesterolemia who did not achieve LDL-C goal for the middle risk patients(<140 mg/dL)with rosuvastatin 2.5 mg/day for more than 3 months treat with the dose of 5 mg/day for at least 3 months. We evaluated changes of parameters on lipid and safety before and after the treatment. Results:In the first study, total 78 patients(26 for each)enrolled into the study. At 3 months, the percent changes of LDL-C were -44.1% in atorvastatin group(ATV), -45.0% in pitavastatin group(PTV), and -39.5% in rosuvastatin group(RSV). LDL-C/HDL-C decreased by 47.2% in ATV, 45.2% in PTV and 40.6% in RSV. There were no significant differences in changes of all lipid parameters among 3 groups. In safety parameters, a significant increase of AST in PTV(p=0.014)at 3 months was observed. In the second study, 13 patients were studied. At 3 months, LDL-C and LDL-C/HDL-C significantly decreased by 25.5% and by 31.4%, respectively(p<0.0001)and HDL-C significantly increased by 7.3% (p=0.013). There were no significant changes in safety parameters during the treatment. Conclusions:Our study showed that usual doses of 3 potent statins have similar efficacy and safety to manage patients with hypercholesterolemia who were newly prescribed statins. Increasing dose from 2.5 mg/day to 5 mg/day of rosuvastatin was shown to be more effective and be safe.