Management of elevated cholesterol in the primary prevention Group of Adult Japanese (MEGA) Study assists the view that a fasting plasma glucose level ≥100mg/dL increases cardiovascular risk

Abstract

Aims/Introduction: To evaluate the relationship between fasting plasma glucose (FPG) level and cardiovascular disease in patients with hypercholesterolemia, and to evaluate the effect of pravastatin on risk reduction in a post-hoc analysis of the large-scale Management of Elevated Cholesterol in the primary prevention Group of Adult Japanese (MEGA) Study. Materials and Methods: A total of 7832 patients were randomized to diet alone or diet plus low-dose pravastatin (10-20mg/day, average 8.3mg during follow-up periods) and followed for >5years. In this analysis, the relationship between FPG and risk of cardiovascular disease events over 5years were studied in 6673 patients with recorded baseline FPG levels by using the multivariable Cox proportional hazards model with the restricted quadratic spline based on three knots for FPG quartiles. Results: The spline curve showed an obvious sharp increased risk from a FPG of ≥100mg/dL. The spline curve in the diet plus pravastatin group was consistently lower than in the diet group, regardless of the FPG level. Conclusions: The risk of cardiovascular disease appears to increase when FPG is ≥100mg/dL, with a sharp increased risk found above this level in patients with hypercholesterolemia. Statin treatment seems to be beneficial to reduce cardiovascular disease risk in this population. This trial was registered with ClinicalTrials.gov (no. NCT00211705). © 2011 Asian Association for the Study of Diabetes and Blackwell Publishing Asia Pty Ltd.