Hidenori Arai1, Hideaki Bujo2, Daisaku Masuda3, Toshiyuki Ishibashi4, Satoshi Nakagawa5, Kenichiro Tanabe5, Tatsuo Kagimura5, Hyun-Jae Kang6, Moo Hyun Kim7, Jidong Sung8, Sang-Hyun Kim9, Cheol-Ho Kim10, Jeong Euy Park11, Junbo Ge12, Byung-Hee Oh13, Toru Kita14, Yasushi Saito15, Masanori Fukushima5, Yuji Matsuzawa16, Shizuya Yamashita17. 1. The National Center for Geriatrics and Gerontology. 2. Department of Clinical Laboratory and Experimental Research Medicine, Toho University, Sakura Medical Center. 3. Rinku Innovation Center for Wellness Care and Activities (RICWA), Rinku General Medical Center. 4. Ohara General Hospital. 5. Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe. 6. Department of Internal Medicine, Seoul National University Hospital and University College of Medicine, Seoul National University. 7. Donga University Hospital. 8. Division of Cardiology, Heart Stroke & Vascular Institute, Samsung Medical Center. 9. Department of Internal Medicine, Seoul Boramae Hospital and Seoul National University College of Medicine. 10. Department of Internal Medicine, Seoul National University Bundang Hospital. 11. Drs. Park and Kim Heart and Lung International Clinic. 12. Department of Cardiology, Zhongshan Hospital, Fudan University. 13. Department of Cardiology, Incheon Sejong Hospital, Incheon. 14. Kobe City College of Nursing. 15. Chiba University Graduate School of Medicine. 16. Sumitomo Hospital. 17. Department of Cardiology, Rinku General Medical Center.
Abstract
AIMS: In this study, we integrated two randomized control trials, PROSPECTIVE and IMPACT, to address the effect of probucol on cerebrocardiovascular events and carotid intima-media thickness (IMT) in Japanese, Korean, and Chinese patients with coronary artery disease (CAD). METHODS: A total of 1,025 patients from the PROSPECTIVE and IMPACT studies were enrolled. The time to the first major adverse cerebrocardiovascular event, in addition to carotid IMT and lipid levels, was compared between the control and probucol groups. RESULTS: In the integrated analysis, the adjusted hazard ratio (HR) and 95% confidence interval (CI) were 0.67 and 0.44-1.03, respectively, indicating a tendency to show the effect of probucol on cerebrocardiovascular events in secondary prevention. We also found no significant differences between the control and probucol groups in the mean IMT of the carotid arteries and its changes. However, we found a significant decrease in cerebrocardiovascular events in patients with reduced levels of HDL cholesterol (HDL-C) (≥ 6.25 mg/dL) compared with those with levels ＜6.25 mg/dL (p=0.024), without any increase in adverse events such as severe ventricular arrhythmias. CONCLUSION: We demonstrated a marginal effect of probucol on cerebrocardiovascular events in Asian patients with CAD, with reasonable safety profiles. A larger study may be needed to support the effect of probucol for cardiovascular prevention.
AIMS: In this study, we integrated two randomized control trials, PROSPECTIVE and IMPACT, to address the effect of probucol on cerebrocardiovascular events and carotid intima-media thickness (IMT) in Japanese, Korean, and Chinese patients with coronary artery disease (CAD). METHODS: A total of 1,025 patients from the PROSPECTIVE and IMPACT studies were enrolled. The time to the first major adverse cerebrocardiovascular event, in addition to carotid IMT and lipid levels, was compared between the control and probucol groups. RESULTS: In the integrated analysis, the adjusted hazard ratio (HR) and 95% confidence interval (CI) were 0.67 and 0.44-1.03, respectively, indicating a tendency to show the effect of probucol on cerebrocardiovascular events in secondary prevention. We also found no significant differences between the control and probucol groups in the mean IMT of the carotid arteries and its changes. However, we found a significant decrease in cerebrocardiovascular events in patients with reduced levels of HDL cholesterol (HDL-C) (≥ 6.25 mg/dL) compared with those with levels ＜6.25 mg/dL (p=0.024), without any increase in adverse events such as severe ventricular arrhythmias. CONCLUSION: We demonstrated a marginal effect of probucol on cerebrocardiovascular events in Asian patients with CAD, with reasonable safety profiles. A larger study may be needed to support the effect of probucol for cardiovascular prevention.
Authors: Louise Bowman; Jemma C Hopewell; Fang Chen; Karl Wallendszus; William Stevens; Rory Collins; Stephen D Wiviott; Christopher P Cannon; Eugene Braunwald; Emily Sammons; Martin J Landray Journal: N Engl J Med Date: 2017-08-28 Impact factor: 91.245
Authors: Henry N Ginsberg; Marshall B Elam; Laura C Lovato; John R Crouse; Lawrence A Leiter; Peter Linz; William T Friedewald; John B Buse; Hertzel C Gerstein; Jeffrey Probstfield; Richard H Grimm; Faramarz Ismail-Beigi; J Thomas Bigger; David C Goff; William C Cushman; Denise G Simons-Morton; Robert P Byington Journal: N Engl J Med Date: 2010-03-14 Impact factor: 91.245
Authors: Philip J Barter; Mark Caulfield; Mats Eriksson; Scott M Grundy; John J P Kastelein; Michel Komajda; Jose Lopez-Sendon; Lori Mosca; Jean-Claude Tardif; David D Waters; Charles L Shear; James H Revkin; Kevin A Buhr; Marian R Fisher; Alan R Tall; Bryan Brewer Journal: N Engl J Med Date: 2007-11-05 Impact factor: 91.245