High-Dose Versus Low-Dose Pitavastatin in Japanese Patients With Stable Coronary Artery Disease (REAL-CAD): A Randomized Superiority Trial
BACKGROUND:Current guidelines call for high-intensity statin therapy in patients with cardiovascular disease on the basis of several previous “more versus less statins” trials. However, no clear evidence for more versus less statins has been established in an Asian population. METHODS:In this prospe...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 2018-05, Vol.137 (19), p.1997-2009 |
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| container_title | Circulation (New York, N.Y.) |
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| creator | Taguchi, Isao Iimuro, Satoshi Iwata, Hiroshi Takashima, Hiroaki Abe, Mitsuru Amiya, Eisuke Ogawa, Takanori Ozaki, Yukio Sakuma, Ichiro Nakagawa, Yoshihisa Hibi, Kiyoshi Hiro, Takafumi Fukumoto, Yoshihiro Hokimoto, Seiji Miyauchi, Katsumi Yamazaki, Tsutomu Ito, Hiroshi Otsuji, Yutaka Kimura, Kazuo Takahashi, Jun Hirayama, Atsushi Yokoi, Hiroyoshi Kitagawa, Kazuo Urabe, Takao Okada, Yasushi Terayama, Yasuo Toyoda, Kazunori Nagao, Takehiko Matsumoto, Masayasu Ohashi, Yasuo Kaneko, Tetsuji Fujita, Retsu Ohtsu, Hiroshi Ogawa, Hisao Daida, Hiroyuki Shimokawa, Hiroaki Saito, Yasushi Kimura, Takeshi Inoue, Teruo Matsuzaki, Masunori Nagai, Ryozo |
| description | BACKGROUND:Current guidelines call for high-intensity statin therapy in patients with cardiovascular disease on the basis of several previous “more versus less statins” trials. However, no clear evidence for more versus less statins has been established in an Asian population.
METHODS:In this prospective, multicenter, randomized, open-label, blinded end point study, 13 054 Japanese patients with stable coronary artery disease who achieved low-density lipoprotein cholesterol (LDL-C) |
| doi_str_mv | 10.1161/CIRCULATIONAHA.117.032615 |
| format | Article |
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METHODS:In this prospective, multicenter, randomized, open-label, blinded end point study, 13 054 Japanese patients with stable coronary artery disease who achieved low-density lipoprotein cholesterol (LDL-C) <120 mg/dL during a run-in period (pitavastatin 1 mg/d) were randomized in a 1-to-1 fashion to high-dose (pitavastatin 4 mg/d; n=6526) or low-dose (pitavastatin 1 mg/d; n=6528) statin therapy. The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal ischemic stroke, or unstable angina requiring emergency hospitalization. The secondary composite end point was a composite of the primary end point and clinically indicated coronary revascularization excluding target-lesion revascularization at sites of prior percutaneous coronary intervention.
RESULTS:The mean age of the study population was 68 years, and 83% were male. The mean LDL-C level before enrollment was 93 mg/dL with 91% of patients taking statins. The baseline LDL-C level after the run-in period on pitavastatin 1 mg/d was 87.7 and 88.1 mg/dL in the high-dose and low-dose groups, respectively. During the entire course of follow-up, LDL-C in the high-dose group was lower by 14.7 mg/dL than in the low-dose group (P<0.001). With a median follow-up of 3.9 years, high-dose as compared with low-dose pitavastatin significantly reduced the risk of the primary end point (266 patients [4.3%] and 334 patients [5.4%]; hazard ratio, 0.81; 95% confidence interval, 0.69–0.95; P=0.01) and the risk of the secondary composite end point (489 patients [7.9%] and 600 patients [9.7%]; hazard ratio, 0.83; 95% confidence interval, 0.73–0.93; P=0.002). High-dose pitavastatin also significantly reduced the risks of several other secondary end points such as all-cause death, myocardial infarction, and clinically indicated coronary revascularization. The results for the primary and the secondary composite end points were consistent across several prespecified subgroups, including the low (<95 mg/dL) baseline LDL-C subgroup. Serious adverse event rates were low in both groups.
CONCLUSIONS:High-dose (4 mg/d) compared with low-dose (1 mg/d) pitavastatin therapy significantly reduced cardiovascular events in Japanese patients with stable coronary artery disease.
CLINICAL TRIAL REGISTRATION:URLhttps://www.clinicaltrials.gov. Unique identifierNCT01042730.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/CIRCULATIONAHA.117.032615</identifier><identifier>PMID: 29735587</identifier><language>eng</language><publisher>United States: by the American College of Cardiology Foundation and the American Heart Association, Inc</publisher><subject>Aged ; Biomarkers - blood ; C-Reactive Protein - metabolism ; Cholesterol, LDL - blood ; Coronary Artery Disease - blood ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - drug therapy ; Coronary Artery Disease - mortality ; Dyslipidemias - blood ; Dyslipidemias - diagnosis ; Dyslipidemias - drug therapy ; Dyslipidemias - mortality ; Female ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects ; Inflammation Mediators - blood ; Japan - epidemiology ; Male ; Middle Aged ; Original s ; Prospective Studies ; Quinolines - administration & dosage ; Quinolines - adverse effects ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome</subject><ispartof>Circulation (New York, N.Y.), 2018-05, Vol.137 (19), p.1997-2009</ispartof><rights>2018 by the American College of Cardiology Foundation and the American Heart Association, Inc.</rights><rights>2018 The Authors.</rights><rights>2018 The Authors. 2018</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4173-b50c8a804353891ef2a842a75d38ea971c4f7d2773fc8e302b18991d5543a5003</citedby><cites>FETCH-LOGICAL-c4173-b50c8a804353891ef2a842a75d38ea971c4f7d2773fc8e302b18991d5543a5003</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,3674,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29735587$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Taguchi, Isao</creatorcontrib><creatorcontrib>Iimuro, Satoshi</creatorcontrib><creatorcontrib>Iwata, Hiroshi</creatorcontrib><creatorcontrib>Takashima, Hiroaki</creatorcontrib><creatorcontrib>Abe, Mitsuru</creatorcontrib><creatorcontrib>Amiya, Eisuke</creatorcontrib><creatorcontrib>Ogawa, Takanori</creatorcontrib><creatorcontrib>Ozaki, Yukio</creatorcontrib><creatorcontrib>Sakuma, Ichiro</creatorcontrib><creatorcontrib>Nakagawa, Yoshihisa</creatorcontrib><creatorcontrib>Hibi, Kiyoshi</creatorcontrib><creatorcontrib>Hiro, Takafumi</creatorcontrib><creatorcontrib>Fukumoto, Yoshihiro</creatorcontrib><creatorcontrib>Hokimoto, Seiji</creatorcontrib><creatorcontrib>Miyauchi, Katsumi</creatorcontrib><creatorcontrib>Yamazaki, Tsutomu</creatorcontrib><creatorcontrib>Ito, Hiroshi</creatorcontrib><creatorcontrib>Otsuji, Yutaka</creatorcontrib><creatorcontrib>Kimura, Kazuo</creatorcontrib><creatorcontrib>Takahashi, Jun</creatorcontrib><creatorcontrib>Hirayama, Atsushi</creatorcontrib><creatorcontrib>Yokoi, Hiroyoshi</creatorcontrib><creatorcontrib>Kitagawa, Kazuo</creatorcontrib><creatorcontrib>Urabe, Takao</creatorcontrib><creatorcontrib>Okada, Yasushi</creatorcontrib><creatorcontrib>Terayama, Yasuo</creatorcontrib><creatorcontrib>Toyoda, Kazunori</creatorcontrib><creatorcontrib>Nagao, Takehiko</creatorcontrib><creatorcontrib>Matsumoto, Masayasu</creatorcontrib><creatorcontrib>Ohashi, Yasuo</creatorcontrib><creatorcontrib>Kaneko, Tetsuji</creatorcontrib><creatorcontrib>Fujita, Retsu</creatorcontrib><creatorcontrib>Ohtsu, Hiroshi</creatorcontrib><creatorcontrib>Ogawa, Hisao</creatorcontrib><creatorcontrib>Daida, Hiroyuki</creatorcontrib><creatorcontrib>Shimokawa, Hiroaki</creatorcontrib><creatorcontrib>Saito, Yasushi</creatorcontrib><creatorcontrib>Kimura, Takeshi</creatorcontrib><creatorcontrib>Inoue, Teruo</creatorcontrib><creatorcontrib>Matsuzaki, Masunori</creatorcontrib><creatorcontrib>Nagai, Ryozo</creatorcontrib><title>High-Dose Versus Low-Dose Pitavastatin in Japanese Patients With Stable Coronary Artery Disease (REAL-CAD): A Randomized Superiority Trial</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>BACKGROUND:Current guidelines call for high-intensity statin therapy in patients with cardiovascular disease on the basis of several previous “more versus less statins” trials. However, no clear evidence for more versus less statins has been established in an Asian population.
METHODS:In this prospective, multicenter, randomized, open-label, blinded end point study, 13 054 Japanese patients with stable coronary artery disease who achieved low-density lipoprotein cholesterol (LDL-C) <120 mg/dL during a run-in period (pitavastatin 1 mg/d) were randomized in a 1-to-1 fashion to high-dose (pitavastatin 4 mg/d; n=6526) or low-dose (pitavastatin 1 mg/d; n=6528) statin therapy. The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal ischemic stroke, or unstable angina requiring emergency hospitalization. The secondary composite end point was a composite of the primary end point and clinically indicated coronary revascularization excluding target-lesion revascularization at sites of prior percutaneous coronary intervention.
RESULTS:The mean age of the study population was 68 years, and 83% were male. The mean LDL-C level before enrollment was 93 mg/dL with 91% of patients taking statins. The baseline LDL-C level after the run-in period on pitavastatin 1 mg/d was 87.7 and 88.1 mg/dL in the high-dose and low-dose groups, respectively. During the entire course of follow-up, LDL-C in the high-dose group was lower by 14.7 mg/dL than in the low-dose group (P<0.001). With a median follow-up of 3.9 years, high-dose as compared with low-dose pitavastatin significantly reduced the risk of the primary end point (266 patients [4.3%] and 334 patients [5.4%]; hazard ratio, 0.81; 95% confidence interval, 0.69–0.95; P=0.01) and the risk of the secondary composite end point (489 patients [7.9%] and 600 patients [9.7%]; hazard ratio, 0.83; 95% confidence interval, 0.73–0.93; P=0.002). High-dose pitavastatin also significantly reduced the risks of several other secondary end points such as all-cause death, myocardial infarction, and clinically indicated coronary revascularization. The results for the primary and the secondary composite end points were consistent across several prespecified subgroups, including the low (<95 mg/dL) baseline LDL-C subgroup. Serious adverse event rates were low in both groups.
CONCLUSIONS:High-dose (4 mg/d) compared with low-dose (1 mg/d) pitavastatin therapy significantly reduced cardiovascular events in Japanese patients with stable coronary artery disease.
CLINICAL TRIAL REGISTRATION:URLhttps://www.clinicaltrials.gov. Unique identifierNCT01042730.</description><subject>Aged</subject><subject>Biomarkers - blood</subject><subject>C-Reactive Protein - metabolism</subject><subject>Cholesterol, LDL - blood</subject><subject>Coronary Artery Disease - blood</subject><subject>Coronary Artery Disease - diagnostic imaging</subject><subject>Coronary Artery Disease - drug therapy</subject><subject>Coronary Artery Disease - mortality</subject><subject>Dyslipidemias - blood</subject><subject>Dyslipidemias - diagnosis</subject><subject>Dyslipidemias - drug therapy</subject><subject>Dyslipidemias - mortality</subject><subject>Female</subject><subject>Humans</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects</subject><subject>Inflammation Mediators - blood</subject><subject>Japan - epidemiology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original s</subject><subject>Prospective Studies</subject><subject>Quinolines - administration & dosage</subject><subject>Quinolines - adverse effects</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Time Factors</subject><subject>Treatment 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Eisuke</creator><creator>Ogawa, Takanori</creator><creator>Ozaki, Yukio</creator><creator>Sakuma, Ichiro</creator><creator>Nakagawa, Yoshihisa</creator><creator>Hibi, Kiyoshi</creator><creator>Hiro, Takafumi</creator><creator>Fukumoto, Yoshihiro</creator><creator>Hokimoto, Seiji</creator><creator>Miyauchi, Katsumi</creator><creator>Yamazaki, Tsutomu</creator><creator>Ito, Hiroshi</creator><creator>Otsuji, Yutaka</creator><creator>Kimura, Kazuo</creator><creator>Takahashi, Jun</creator><creator>Hirayama, Atsushi</creator><creator>Yokoi, Hiroyoshi</creator><creator>Kitagawa, Kazuo</creator><creator>Urabe, Takao</creator><creator>Okada, Yasushi</creator><creator>Terayama, Yasuo</creator><creator>Toyoda, Kazunori</creator><creator>Nagao, Takehiko</creator><creator>Matsumoto, Masayasu</creator><creator>Ohashi, Yasuo</creator><creator>Kaneko, Tetsuji</creator><creator>Fujita, Retsu</creator><creator>Ohtsu, Hiroshi</creator><creator>Ogawa, Hisao</creator><creator>Daida, 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Seiji ; Miyauchi, Katsumi ; Yamazaki, Tsutomu ; Ito, Hiroshi ; Otsuji, Yutaka ; Kimura, Kazuo ; Takahashi, Jun ; Hirayama, Atsushi ; Yokoi, Hiroyoshi ; Kitagawa, Kazuo ; Urabe, Takao ; Okada, Yasushi ; Terayama, Yasuo ; Toyoda, Kazunori ; Nagao, Takehiko ; Matsumoto, Masayasu ; Ohashi, Yasuo ; Kaneko, Tetsuji ; Fujita, Retsu ; Ohtsu, Hiroshi ; Ogawa, Hisao ; Daida, Hiroyuki ; Shimokawa, Hiroaki ; Saito, Yasushi ; Kimura, Takeshi ; Inoue, Teruo ; Matsuzaki, Masunori ; Nagai, Ryozo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4173-b50c8a804353891ef2a842a75d38ea971c4f7d2773fc8e302b18991d5543a5003</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Aged</topic><topic>Biomarkers - blood</topic><topic>C-Reactive Protein - metabolism</topic><topic>Cholesterol, LDL - blood</topic><topic>Coronary Artery Disease - blood</topic><topic>Coronary Artery Disease - diagnostic imaging</topic><topic>Coronary Artery Disease - drug therapy</topic><topic>Coronary Artery Disease - mortality</topic><topic>Dyslipidemias - blood</topic><topic>Dyslipidemias - diagnosis</topic><topic>Dyslipidemias - drug therapy</topic><topic>Dyslipidemias - mortality</topic><topic>Female</topic><topic>Humans</topic><topic>Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage</topic><topic>Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects</topic><topic>Inflammation Mediators - blood</topic><topic>Japan - epidemiology</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original s</topic><topic>Prospective Studies</topic><topic>Quinolines - administration & dosage</topic><topic>Quinolines - adverse effects</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Taguchi, 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Hiroyoshi</creatorcontrib><creatorcontrib>Kitagawa, Kazuo</creatorcontrib><creatorcontrib>Urabe, Takao</creatorcontrib><creatorcontrib>Okada, Yasushi</creatorcontrib><creatorcontrib>Terayama, Yasuo</creatorcontrib><creatorcontrib>Toyoda, Kazunori</creatorcontrib><creatorcontrib>Nagao, Takehiko</creatorcontrib><creatorcontrib>Matsumoto, Masayasu</creatorcontrib><creatorcontrib>Ohashi, Yasuo</creatorcontrib><creatorcontrib>Kaneko, Tetsuji</creatorcontrib><creatorcontrib>Fujita, Retsu</creatorcontrib><creatorcontrib>Ohtsu, Hiroshi</creatorcontrib><creatorcontrib>Ogawa, Hisao</creatorcontrib><creatorcontrib>Daida, Hiroyuki</creatorcontrib><creatorcontrib>Shimokawa, Hiroaki</creatorcontrib><creatorcontrib>Saito, Yasushi</creatorcontrib><creatorcontrib>Kimura, Takeshi</creatorcontrib><creatorcontrib>Inoue, Teruo</creatorcontrib><creatorcontrib>Matsuzaki, Masunori</creatorcontrib><creatorcontrib>Nagai, Ryozo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Taguchi, Isao</au><au>Iimuro, Satoshi</au><au>Iwata, Hiroshi</au><au>Takashima, Hiroaki</au><au>Abe, Mitsuru</au><au>Amiya, Eisuke</au><au>Ogawa, Takanori</au><au>Ozaki, Yukio</au><au>Sakuma, Ichiro</au><au>Nakagawa, Yoshihisa</au><au>Hibi, Kiyoshi</au><au>Hiro, Takafumi</au><au>Fukumoto, Yoshihiro</au><au>Hokimoto, Seiji</au><au>Miyauchi, Katsumi</au><au>Yamazaki, Tsutomu</au><au>Ito, Hiroshi</au><au>Otsuji, Yutaka</au><au>Kimura, Kazuo</au><au>Takahashi, Jun</au><au>Hirayama, Atsushi</au><au>Yokoi, Hiroyoshi</au><au>Kitagawa, Kazuo</au><au>Urabe, Takao</au><au>Okada, Yasushi</au><au>Terayama, Yasuo</au><au>Toyoda, Kazunori</au><au>Nagao, Takehiko</au><au>Matsumoto, Masayasu</au><au>Ohashi, Yasuo</au><au>Kaneko, Tetsuji</au><au>Fujita, Retsu</au><au>Ohtsu, Hiroshi</au><au>Ogawa, Hisao</au><au>Daida, Hiroyuki</au><au>Shimokawa, Hiroaki</au><au>Saito, Yasushi</au><au>Kimura, Takeshi</au><au>Inoue, Teruo</au><au>Matsuzaki, Masunori</au><au>Nagai, Ryozo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High-Dose Versus Low-Dose Pitavastatin in Japanese Patients With Stable Coronary Artery Disease (REAL-CAD): A Randomized Superiority Trial</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2018-05-08</date><risdate>2018</risdate><volume>137</volume><issue>19</issue><spage>1997</spage><epage>2009</epage><pages>1997-2009</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><abstract>BACKGROUND:Current guidelines call for high-intensity statin therapy in patients with cardiovascular disease on the basis of several previous “more versus less statins” trials. However, no clear evidence for more versus less statins has been established in an Asian population.
METHODS:In this prospective, multicenter, randomized, open-label, blinded end point study, 13 054 Japanese patients with stable coronary artery disease who achieved low-density lipoprotein cholesterol (LDL-C) <120 mg/dL during a run-in period (pitavastatin 1 mg/d) were randomized in a 1-to-1 fashion to high-dose (pitavastatin 4 mg/d; n=6526) or low-dose (pitavastatin 1 mg/d; n=6528) statin therapy. The primary end point was a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal ischemic stroke, or unstable angina requiring emergency hospitalization. The secondary composite end point was a composite of the primary end point and clinically indicated coronary revascularization excluding target-lesion revascularization at sites of prior percutaneous coronary intervention.
RESULTS:The mean age of the study population was 68 years, and 83% were male. The mean LDL-C level before enrollment was 93 mg/dL with 91% of patients taking statins. The baseline LDL-C level after the run-in period on pitavastatin 1 mg/d was 87.7 and 88.1 mg/dL in the high-dose and low-dose groups, respectively. During the entire course of follow-up, LDL-C in the high-dose group was lower by 14.7 mg/dL than in the low-dose group (P<0.001). With a median follow-up of 3.9 years, high-dose as compared with low-dose pitavastatin significantly reduced the risk of the primary end point (266 patients [4.3%] and 334 patients [5.4%]; hazard ratio, 0.81; 95% confidence interval, 0.69–0.95; P=0.01) and the risk of the secondary composite end point (489 patients [7.9%] and 600 patients [9.7%]; hazard ratio, 0.83; 95% confidence interval, 0.73–0.93; P=0.002). High-dose pitavastatin also significantly reduced the risks of several other secondary end points such as all-cause death, myocardial infarction, and clinically indicated coronary revascularization. The results for the primary and the secondary composite end points were consistent across several prespecified subgroups, including the low (<95 mg/dL) baseline LDL-C subgroup. Serious adverse event rates were low in both groups.
CONCLUSIONS:High-dose (4 mg/d) compared with low-dose (1 mg/d) pitavastatin therapy significantly reduced cardiovascular events in Japanese patients with stable coronary artery disease.
CLINICAL TRIAL REGISTRATION:URLhttps://www.clinicaltrials.gov. Unique identifierNCT01042730.</abstract><cop>United States</cop><pub>by the American College of Cardiology Foundation and the American Heart Association, Inc</pub><pmid>29735587</pmid><doi>10.1161/CIRCULATIONAHA.117.032615</doi><tpages>13</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0009-7322 |
| ispartof | Circulation (New York, N.Y.), 2018-05, Vol.137 (19), p.1997-2009 |
| issn | 0009-7322 1524-4539 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5959207 |
| source | MEDLINE; American Heart Association Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Journals@Ovid Complete |
| subjects | Aged Biomarkers - blood C-Reactive Protein - metabolism Cholesterol, LDL - blood Coronary Artery Disease - blood Coronary Artery Disease - diagnostic imaging Coronary Artery Disease - drug therapy Coronary Artery Disease - mortality Dyslipidemias - blood Dyslipidemias - diagnosis Dyslipidemias - drug therapy Dyslipidemias - mortality Female Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects Inflammation Mediators - blood Japan - epidemiology Male Middle Aged Original s Prospective Studies Quinolines - administration & dosage Quinolines - adverse effects Risk Assessment Risk Factors Time Factors Treatment Outcome |
| title | High-Dose Versus Low-Dose Pitavastatin in Japanese Patients With Stable Coronary Artery Disease (REAL-CAD): A Randomized Superiority Trial |
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