High-dose statin therapy with rosuvastatin reduces small dense LDL and MDA-LDL: The Standard versus high-dose therApy with Rosuvastatin for lipiD lowering (SARD) trial
High-dose statin therapy with rosuvastatin reduces small dense LDL and MDA-LDL: The Standard versus high-dose therApy with Rosuvastatin for lipiD lowering (SARD) trial
复制标题
DOI：
10.1016/j.jjcc.2015.05.017
复制
发表时间：
2016-03-01
影响因子：
2.5
通讯作者：
Node, Koichi
中科院分区：
文献类型：
--
作者：
Nishikido, Toshiyuki;Oyama, Jun-ichi;Node, Koichi
背景：尽管他汀类药物显著降低了低密度脂蛋白胆固醇(LDL)，但由于高危患者的残余风险，心血管事件(CV)仍在继续发生。据报道，高致动脉粥样硬化颗粒中的小密度低密度脂蛋白(SD-LDL)成分与心血管疾病的风险增加有关，而不是大的浮力低密度脂蛋白。方法与结果：在这项前瞻性、随机、开放、多中心的研究中，111例高危患者被随机分为两组。大剂量治疗组58例，给予瑞舒伐他汀5 mg/d，连续4周，此后剂量滴定至10 mg，持续8周。小剂量治疗组53例，口服2.5 mg，疗程12周。我们评估了血脂谱，包括SD-低密度脂蛋白、丙二醛修饰的低密度脂蛋白(C)(氧化低密度脂蛋白)和残留颗粒-胆固醇的水平。高剂量治疗组大鼠血清低密度脂蛋白、非高密度脂蛋白、低密度脂蛋白/高密度脂蛋白比值明显降低(P<0.01)。此外，高剂量治疗组的SD-LDL和MDA-LDL水平显著降低(p<；0.05)。两组均未发生严重不良事件。结论：与小剂量他汀类药物治疗相比，大剂量他汀类药物治疗可显著降低动脉粥样硬化性脂蛋白中SD-LDL和MDA-LDL的含量，且无不良事件发生。(C)2015年日本心脏病学院。爱思唯尔有限公司出版。保留所有权利。
Background: Cardiovascular events (CV) continue to occur due to residual risks in high-risk patients in spite of substantial reductions in the low-density lipoprotein cholesterol (LDL) with statins. It has been reported that the small-dense LDL (sd-LDL) components of high atherogenic particles are associated with an increased risk of CV, more than large buoyant LDL. However, there are few reports regarding the effects of high-dose statin therapy in improving atherogenic lipoproteins.Methods and results: In this prospective, randomized, open-label, multicenter study, a total of 111 high-risk patients were randomly assigned to two groups. In the high-dose therapy group, 58 patients were administered 5 mg of rosuvastatin per day for four weeks, after which the dose was titrated to 10 mg for the following eight weeks. In the low-dose therapy group, 53 patients were given 2.5 mg for 12 weeks. We evaluated the lipid profiles, including the levels of sd-LDL, malondialdehyde-modified LDL-cholesterol (C) (MDA-LDL) as oxidized-LDL, and remnant-like particle-cholesterol. The LDL-C, non-high-density lipoprotein (HDL), and LDL-C/HDL-C ratio were decreased in the high-dose therapy group (p < 0.01). Moreover, the sd-LDL and MDA-LDL levels were significantly reduced in the high-dose therapy group (p < 0.05). There were no serious adverse events in either group.Conclusions: High-dose statin therapy significantly reduced the sd-LDL and MDA-LDL components of atherosclerotic lipoproteins without adverse events in comparison with low-dose statin therapy. (C) 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.