2023 Fiscal Year Final Research Report
Clinical significance of high-density lipoprotein cholesterol uptake capacity in patients with stable coronary artery disease
| Project/Area Number |
21K07403
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Review Section |
Basic Section 52010:General internal medicine-related
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| Research Institution | Fujita Health University |
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Principal Investigator |
Ishii Junnichi 藤田医科大学, 医学部, 客員教授 (70222940)
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| Co-Investigator(Kenkyū-buntansha) |
成瀬 寛之 藤田医科大学, 医療科学部, 教授 (50319266)
西村 豪人 藤田医科大学, 医学部, 助教 (40837423)
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| Project Period (FY) |
2021-04-01 – 2024-03-31
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| Keywords | 高比重リポ蛋白コレステロール取り込み能 / 酸化リポプロテイン(a) / 安定冠動脈疾患 / スタチン / 残余リスク / 主要心血管イベント. |
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| Outline of Final Research Achievements |
High-density lipoprotein cholesterol uptake capacity (HDL-CUC), a new measure of HDL functionality, and oxidized lipoprotein(a)[OxLp(a)] are attracting attention as residual risk factors for major adverse cardiovascular events (MACEs) in patients with stable coronary artery disease (CAD). A case-cohort study was conducted involving stable CAD patients from the Randomized Evaluation of Aggressive or Moderate Lipid-Lowering Therapy with Pitavastatin in Coronary Artery Disease (REAL-CAD) study. HDL-CUC and OxLp(a) at baseline and 6 months after randomization were measured in 2061 participants selected from the REAL-CAD study population. After multivariable adjustment, higher OxLp(a) at 6 months were significantly associated with a higher residual risk of MACEs. However, the significant association between HDL-CUC at 6 months and the residual risk of MACEs was not observed. In conclusion, OxLp(a) may be a potent marker of residual risk of MACEs in statin-treated patients with stable CAD.
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| Free Research Field |
循環器病学
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| Academic Significance and Societal Importance of the Research Achievements |
大規模臨床試験の成績では低比重リポ蛋白コレステロール（LDL-C）低下療法による心血管イベントの抑制効果はせいぜい40％程度である。したがって、心血管イベントの抑制にはLDL-Cとは別の残余リスクを同定し介入することが重要である。特に、二次予防は一次予防に比べて心血管イベントの発症率が5倍以上高いことから、二次予防ではスタチン治療後の残余リスクを同定し介入することが喫緊の課題である。本研究は酸化リポプロテイン(a)が二次予防におけるスタチン治療後の残余リスクの有用なマーカーであることを明らかにした。この新知見は酸化リポプロテイン(a)に基づく新たな2次予防戦略の構築に繋がると考えられる。
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