As shown in the MEGA study (Management of Elevated Cholesterol in the Primary Prevention Group of Adult Japanese Study) designed to evaluate the effect of low dose of pravastatin (8.3 mg/day, on average) in the primary prevention of coronary artery disease (CAD) in Japanese subjects, some Japanese subjects were found to be especially sensitive to statin therapy. The suppressive effect of statins on coronary plaque progression was more marked in the study conducted in Western subjects than in previous trials in Western subjects. The responses of coronary atherosclerosis to statin treatment might differ markedly between Japanese and Western subjects. Thus, a beneficial reduction in the risk of CAD might be achieved with a small improvement in the lipid profile. There seems to be an urgent need to gather evidence regarding the effects of statins on the regression of coronary atherosclerosis and the inhibition of ischemic heart events in Japanese patients who show favorable sensitivity to statins.
