Abstract 14143: Comparison of Lipid Parameters as a Predictor of Cardiovascular Disease and Effects of Low Dose Pravastatin in Japanese Patients With and Without Diabetes Mellitus.
Background and aims: We compared the relationship between cardiovascular disease and lipid parameters (low density lipoprotein cholesterol [LDL-C], the ratio of LDL-C per high-density lipoprotein cholesterol [LDL-C/HDL-C], and non-HDL-C [NHDL-C]) in hypercholesterolemic Japanese with and without diabetes mellitus (DM), and evaluated the relationship between these lipid parameters and pravastatin treatment using MEGA Study data, a large scale clinical trial with pravastatin in primary prevention of cardiovascular disease conducted in Japan, a country with low incidence of cardiovascular disease.
Materials and methods: The 7832 patients were randomized to diet alone (n=3966) or diet + pravastatin (n=3866) and followed for an average 5 years. In diet group, Non DM (n=2,502) and DM (n=668) were divided into tertiles of baseline LDL-C, LDL-C/HDL-C, and non-HDL-C to compare the incidence of coronary heart disease (CHD) plus cerebral infarction (CI), and to compare the effect of pravastatin treatment in each group.
Results: The hazard ratios for CHD plus CI are summarized in the Table. Although a significant increase in cardiovascular risk was observed for each lipid parameter in both DM and non DM patients, the use of NHDL-C captured more marked rise in the second tertile of DM patients. A significant and large 66% risk reduction in CHD plus CI with pravastatin was observed in the high NHDL-C tertile (≥5.0 mmol/L) of DM patients, with a very low number needed to treat (NNT) of 16 to prevent 1 CHD plus CI event.
Conclusions: The best lipid parameter to predict cardiovascular complications was NHDL-C regardless of whether or not diabetes . Low-dose pravastatin treatment markedly reduces the ischemic cardiovascular disease risk with very low NNT in diabetic patients with a NHDL-C greater than 5.0 mmol/L in Japanese, even in a country with low burden of cardiovascular diasease.
- © 2010 by American Heart Association, Inc.