Randomized Evaluation of Aggressive or Moderate Lipid Lowering Therapy with Pitavastatin in Coronary Artery Disease(REAL-CAD)

• Register: JPRN
• Last refreshed on: 26 April 2013
• Main ID: JPRN-UMIN000002680
• Date of registration: 27/10/2009
• Primary sponsor: Public Health Research Foundation
• Public title: Randomized Evaluation of Aggressive or Moderate Lipid Lowering Therapy with Pitavastatin in Coronary Artery Disease(REAL-CAD)
• Date of first enrolment: 2010/01/01
• Target sample size: 12600
• Recruitment status: Open public recruiting
• URL: http://www.umin.ac.jp/ctr/index.htm
• Study type: Interventional
• Study design: Parallel Randomized

Countries of recruitment

Japan,Asia(except Japan)

Contacts

• Name: Teruhiko Miyazaki
• Affiliation: Public Health Research Foundation Comprehensive Support Project for Clinical Research

• Name: Satoshi Iimuro
• Affiliation: The University of Tokyo Faculty of medicine

Key inclusion & exclusion criteria

Inclusion criteria: Patients who met following all criteria were entered in run-in period, loading pitavastatin 1 mg/day for more than 1 month when informed consent was given. (Primary registration)
(1) Coronary artery disease patients
Meeting one of following events
1) History of Acute Coronary Syndrome (AMI or Unstable angina)
2) History of revascularization (PCI or CABG)
3) Diagnosis of ischemic heart disease and coronary artery stenosis as having 75% or higher stenosis according to the AHA classification
(2) Hypercholesterolemia patients
Meeting one of following criteria
1) LDL-C is 140 mg/dL or over
2) LDL-C is 100 mg/dL or over and requiring cholesterol lowering drugs judged by attending physicians
3) Patents receiving cholesterol lowering drugs
(3) Age (20<= <80 year-old)
(4) Patients given written informed consent.
Exclusion criteria: Exclusion Criteria(1) (Pre-Run-in period)
1. Patients planed revascularization
2. Malignant tumor in active phase
3. Patients who meet contraindication of LIVALO tablet below
1) Patients who have hypersensitivity to LIVALO tablet
2) Patients who have severe liver dysfunction or biliary atresia.
3)Patients who are being treated with cyclosporine
4) Pregnant women, women suspected of being pregnant, or lactating women
4. Patients who have heart failure NYHA III or greater
5. Patients undergoing dialysis
6. Patients with familial hypercholesterolemia
7. Patients registered in the other clinical trials
8. Patients with prohibited drugs
9. Patients who are ineligible in the opinion of the investigator

Exclusion Criteria(2) (Post-Run-in period)
1. LDL-C is 120mg/dL or over after Run-in period
2. Patients with occurrence of acute coronary syndrome (AMI or Unstable angina) within 3 months
3. Patients who have been undergone PCI or CABG within 3 months
4. Compliance is less than 50% in Run-in period
5. Patients who met primary endpoint or adverse events in Run-in period and judged as ineligible in the opinion of the investigator
6. Patients who are ineligible in the opinion of the investigator

Age minimum: 20years-old
Age maximum: 80years-old
Gender: Male and Female

Health Condition(s) or Problem(s) studied

Patients with stable coronary artery disease

Intervention(s)

Pitavastatin 4 mg daily
Pitavastatin 1 mg daily

Primary Outcome(s)

Occurrence of one of following events
1. Cardiovascular death
2. Non-fatal Myocardial Infarction
3. Non-fatal Cerebral Infarction
4.Unstable angina requiring urgent hospitalizations

Secondary Outcome(s)

1.Composite cardiovascular events
Occurrence of one of following events
Cardiovascular death, Non-fatal MI, Non-fatal CI, Unstable angina requiring hospitalizations, Ischemia-driven coronary revascularization except target lesion revascularization (TLR)
2. Composite coronary heart disease events
Occurrence of one of following events
Coronary heart disease (CHD) death, Non-fatal MI, Unstable angina requiring urgent hospitalizations, Ischemia-driven coronary revascularization except TLR.
3.Composite cerebrovascular events
Occurrence of one of following events
Fatal and Non-fatal stroke, Transient ischemic attack (TIA) requiring hospitalizations.
4.Death events
Occurrence of each following events
All-cause mortality
Cardiovascular death
Cardiac death
CHD death
5.Heart disease events
Occurrence of each following events
Fatal and Non-fatal MI
Non-procedure related MI
Procedure related MI
Unstable angina requiring urgent hospitalizations
Resuscitated cardiac arrest
Hospitalization for heart failure
PCI or CABG
(1)All events of PCI or CABG
(a)TLR
(b)non-TLR
(2)Ischemia-driven PCI or CABG
(a)TLR
(b)non-TLR
6. Cerebrovascular events
Occurrence of each following events
Fatal and Non-fatal stroke
Fatal and Non-fatal CI
(1) Non-procedure related CI
(2) Procedure related CI
Fatal and Non-fatal cerebral hemorrhage
Hospitalization for TIA
7. The other events
Occurrence of each following events
Operation for or rupture of aortic aneurysm
Revascularization for peripheral arterial disease (PAD)
Carotid artery stenting (CAS) or carotid endarterectomy (CEA)
Aortic dissection
Deep vein thrombosis (DVT) or pulmonary thromboembolism (PTE)
New occurrence of malignant tumor
Operation for aortic stenosis

Source(s) of Monetary Support

Public Health research Foundation