{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T23:44:37Z","timestamp":1761867877763,"version":"build-2065373602"},"reference-count":12,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,12,6]],"date-time":"2018-12-06T00:00:00Z","timestamp":1544054400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005612","name":"Shionogi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005612","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["dom-pubs.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Diabetes Obesity Metabolism"],"published-print":{"date-parts":[[2019,4]]},"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To assess the benefits of intensive statin therapy on reducing cardiovascular (CV) events in patients with type 2 diabetes complicated with hyperlipidaemia and retinopathy in a primary prevention setting in Japan. In the intension\u2010to\u2010treat population, intensive therapy [targeting LDL cholesterol &lt;1.81 mmol\/L (&lt;70 mg\/dL)] was no more effective than standard therapy [LDL cholesterol \u22652.59 to &lt;3.10 mmol\/L (\u2265100 to &lt;120 mg\/dL)]; however, after 3 years, the intergroup difference in LDL cholesterol was only 0.72 mmol\/L (27.7 mg\/dL), and targeted levels were achieved in &lt;50% of patients. We hypothesized that the intergroup difference in CV events would have been statistically significant if more patients had been successfully treated to target.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>This exploratory post hoc analysis focused on intergroup data from patients who achieved their target LDL cholesterol levels. The primary endpoint was the composite incidence of CV events. A Cox proportional hazards model was used to estimate hazard ratios (HRs) for incidence of the primary endpoint in patients who achieved target LDL cholesterol levels in each group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Data were analysed from 1909 patients (intensive: 703; standard: 1206) who achieved target LDL cholesterol levels. LDL cholesterol at 36\u2009months was 1.54\u2009\u00b1\u20090.30\u2009mmol\/L (59.7\u2009\u00b1\u200911.6\u2009mg\/dL) in the intensive group and 2.77\u2009\u00b1\u20090.46 mmol\/L (107.1\u2009\u00b1\u200917.8\u2009mg\/dL) in the standard group (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.05). After adjusting for baseline prognostic factors, the composite incidence of CV events or deaths associated with CV events was significantly lower in the intensive than the standard group (HR 0.48; 95% confidence interval 0.28\u20100.82;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.007).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This post hoc analysis suggests that achieving LDL cholesterol target levels &lt;1.81\u2009mmol\/L may more effectively reduce CV events than achieving target levels \u22652.59 to &lt;3.10 mmol\/L in patients with hypercholesterolaemia and diabetic retinopathy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/dom.13575","type":"journal-article","created":{"date-parts":[[2018,11,5]],"date-time":"2018-11-05T01:29:26Z","timestamp":1541381366000},"page":"791-800","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Achieving LDL cholesterol target levels &lt;1.81 mmol\/L may provide extra cardiovascular protection in patients at high risk: Exploratory analysis of the Standard Versus Intensive Statin Therapy for Patients with Hypercholesterolaemia and Diabetic Retinopathy study"],"prefix":"10.1111","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2514-4919","authenticated-orcid":false,"given":"Hiroshi","family":"Itoh","sequence":"first","affiliation":[{"name":"Department of Endocrinology, Metabolism and Nephrology Keio University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Issei","family":"Komuro","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine University of Tokyo Graduate School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Takeuchi","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine (Biostatistics and Pharmaceutical Medicine) School of Pharmacy, Kitasato University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Akasaka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Wakayama Medical University  Wakayama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Daida","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Graduate School of Medicine Juntendo University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshiki","family":"Egashira","sequence":"additional","affiliation":[{"name":"Sakura Hospital  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hideo","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Cardiology Saitama Medical Centre, Jichi Medical University  Saitama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jitsuo","family":"Higaki","sequence":"additional","affiliation":[{"name":"Department of Integrated Medicine and Informatics Ehime University Graduate School of Medicine  Toon Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ken\u2010ichi","family":"Hirata","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine Kobe University Graduate School of Medicine  Kobe Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shun","family":"Ishibashi","sequence":"additional","affiliation":[{"name":"Division of Endocrinology and Metabolism, Department of Internal Medicine Jichi Medical University  Shimotsuke Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takaaki","family":"Isshiki","sequence":"additional","affiliation":[{"name":"Division of Cardiology Cardiovascular Centre, Ageo Central General Hospital  Ageo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sadayoshi","family":"Ito","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Endocrinology and Vascular Medicine Tohoku University Graduate School of Medicine  Sendai Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsunori","family":"Kashiwagi","sequence":"additional","affiliation":[{"name":"Kusatsu General Hospital  Kusatsu Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Kato","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology University of Tokyo Graduate School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuo","family":"Kitagawa","sequence":"additional","affiliation":[{"name":"Department of Neurology Tokyo Women's Medical University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masafumi","family":"Kitakaze","sequence":"additional","affiliation":[{"name":"Division of Cardiology National Cerebral and Cardiovascular Centre  Suita Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takanari","family":"Kitazono","sequence":"additional","affiliation":[{"name":"Department of Medicine and Clinical Science Graduate School of Medical Sciences, Kyushu University  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiko","family":"Kurabayashi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Biological Science Gunma University Graduate School of Medicine  Maebashi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katsumi","family":"Miyauchi","sequence":"additional","affiliation":[{"name":"Department of Cardiology Graduate School of Medicine Juntendo University  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomoaki","family":"Murakami","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology Kyoto University Graduate School of Medicine  Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toyoaki","family":"Murohara","sequence":"additional","affiliation":[{"name":"Department of Cardiology Nagoya University Graduate School of Medicine  Nagoya Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2534-0939","authenticated-orcid":false,"given":"Koichi","family":"Node","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Saga University  Saga Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5489-9259","authenticated-orcid":false,"given":"Susumu","family":"Ogawa","sequence":"additional","affiliation":[{"name":"Division of Nephrology, Endocrinology and Vascular Medicine Tohoku University Hospital  Sendai Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiko","family":"Saito","sequence":"additional","affiliation":[{"name":"First Department of Internal Medicine Nara Medical University  Kashihara Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshihiko","family":"Seino","sequence":"additional","affiliation":[{"name":"Department of Cardiology Nippon Medical School Chiba Hokusoh Hospital  Inzai Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Shigeeda","sequence":"additional","affiliation":[{"name":"Ideta Eye Clinic  Kumamoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shunya","family":"Shindo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery Tokyo Medical University Hachioji Medical Centre  Hachioji Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Sugawara","sequence":"additional","affiliation":[{"name":"Sugawara Medical Clinic  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seigo","family":"Sugiyama","sequence":"additional","affiliation":[{"name":"Department of Cardiology Jinnouchi Hospital  Kumamoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8872-3697","authenticated-orcid":false,"given":"Yasuo","family":"Terauchi","sequence":"additional","affiliation":[{"name":"Department of Endocrinology and Metabolism Yokohama City University School of Medicine  Yokohama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Tsutsui","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Faculty of Medical Sciences, Kyushu University  Fukuoka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Ueshima","sequence":"additional","affiliation":[{"name":"Department of EBM Research Institute for Advancement of Clinical and Translational Science, Kyoto University Hospital  Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazunori","family":"Utsunomiya","sequence":"additional","affiliation":[{"name":"Division of Diabetes, Metabolism and Endocrinology, Department of Internal Medicine Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masakazu","family":"Yamagishi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Internal Medicine Kanazawa University Graduate School of Medicine  Kanazawa Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tsutomu","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Clinical Research Support Centre, University of Tokyo Hospital  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shoei","family":"Yo","sequence":"additional","affiliation":[{"name":"Yo Clinic  Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koutaro","family":"Yokote","sequence":"additional","affiliation":[{"name":"Department of Clinical Cell Biology and Medicine Chiba University Graduate School of Medicine  Chiba Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiyoshi","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Sakakibara Heart Institute of Okayama  Okayama Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michihiro","family":"Yoshimura","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine Jikei University School of Medicine  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nagahisa","family":"Yoshimura","sequence":"additional","affiliation":[{"name":"Kitano Hospital, Tazuke Kofukai Medical Research Institute  Osaka Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuwa","family":"Nakao","sequence":"additional","affiliation":[{"name":"Medical Innovation Centre, Kyoto University Graduate School of Medicine  Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryozo","family":"Nagai","sequence":"additional","affiliation":[{"name":"Jichi Medical University  Shimotsuke Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the EMPATHY Investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,12,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.316.7134.823"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2011-0622"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2337\/diabetes.53.suppl_3.S39"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc11-0079"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtcvs.2009.04.005"},{"key":"e_1_2_7_7_1","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.2337\/dc17-2224","article-title":"EMPATHY Investigators. Intensive treat\u2010to\u2010target statin therapy in high\u2010risk Japanese patients with hypercholesterolemia and diabetic retinopathy: report of a randomized study","volume":"41","author":"Itoh H","year":"2018","journal-title":"Diabetes Care"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)60104-X"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2007.03.102"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.2337\/dc05-2465"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2010.09.082"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1177\/1741826710389391"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.5551\/jat.33563"}],"container-title":["Diabetes, Obesity and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fdom.13575","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/dom.13575","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/dom.13575","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/pdf\/10.1111\/dom.13575","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T23:40:41Z","timestamp":1761867641000},"score":1,"resource":{"primary":{"URL":"https:\/\/dom-pubs.pericles-prod.literatumonline.com\/doi\/10.1111\/dom.13575"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12,6]]},"references-count":12,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2019,4]]}},"alternative-id":["10.1111\/dom.13575"],"URL":"https:\/\/doi.org\/10.1111\/dom.13575","archive":["Portico"],"relation":{},"ISSN":["1462-8902","1463-1326"],"issn-type":[{"type":"print","value":"1462-8902"},{"type":"electronic","value":"1463-1326"}],"subject":[],"published":{"date-parts":[[2018,12,6]]},"assertion":[{"value":"2018-07-27","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-10-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-12-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}