Statin Treatment in Patients With Stroke With Low-Density Lipoprotein Cholesterol Levels Below 70 mg/dLopen access
- Authors
- Kim, Joon-Tae; Lee, Ji Sung; Kim, Beom Joon; Kang, Jihoon; Lee, Keon-Joo; Park, Jong-Moo; Kang, Kyusik; Lee, Soo Joo; Kim, Jae Guk; Cha, Jae-Kwan; Kim, Dae-Hyun; Park, Tai Hwan; Lee, Kyungbok; Lee, Jun; Hong, Keun-Sik; Cho, Yong-Jin; Park, Hong-Kyun; Lee, Byung-Chul; Yu, Kyung-Ho; Oh, Mi Sun; Kim, Dong-Eog; Ryu, Wi-Sun; Choi, Jay Chol; Kwon, Jee-Hyun; Kim, Wook-Joo; Shin, Dong-Ick; Yum, Kyu Sun; Sohn, Sung Il; Hong, Jeong-Ho; Lee, Sang-Hwa; Park, Man-Seok; Choi, Kang-Ho; Lee, Juneyoung; Park, Kwang-Yeol; Bae, Hee-Joon
- Issue Date
- Sep-2023
- Publisher
- Wiley-Blackwell
- Keywords
- acute ischemic stroke; early vascular outcomes; LDL-C; statin
- Citation
- Journal of the American Heart Association, v.12, no.18
- Indexed
- SCIE
SCOPUS
- Journal Title
- Journal of the American Heart Association
- Volume
- 12
- Number
- 18
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64894
- DOI
- 10.1161/JAHA.123.030738
- ISSN
- 2047-9980
2047-9980
- Abstract
- Background: It is unclear whether statin treatment could reduce the risk of early vascular events when baseline low-density lipoprotein cholesterol (LDL-C) levels are already low, at <70mg/dL, at the time of the index stroke. Methods and Results: This study was an analysis of a prospective, multicenter, nationwide registry of consecutive patients with first-ever acute ischemic stroke with baseline low-density lipoprotein cholesterol levels <70mg/dL and without statin pretreatment. An inverse probabilities of treatment weights method was applied to control for imbalances in baseline characteristics. The primary outcome was a composite of stroke (either hemorrhagic or ischemic), myocardial infarction, and all-cause death within 3months. A total of 2850 patients (age, 69.513.4 years; men, 63.5%) were analyzed for this study. In-hospital statin treatment was used for 74.2% of patients. The primary composite outcome within 3months occurred in 21.5% of patients in the nonstatin group and 6.7% of patients in the statin group (P<0.001), but the rates of stroke (2.65% versus 2.33%), hemorrhagic stroke (0.16% versus 0.10%), and myocardial infarction (0.73% versus 0.19%) were not significantly different between the 2 groups. After inverse probability of treatment weighting analysis, the primary composite outcome was significantly reduced in patients with statin therapy (weighted hazard ratio [HR], 0.54 [95% CI, 0.42-0.69]). However, statin treatment did not increase the risk of hemorrhagic stroke (weighted HR, 1.11 [95% CI, 0.10-12.28]). Conclusions: Approximately three-quarters of the patients with first-ever ischemic stroke with baseline low-density lipoprotein cholesterol levels <70mg/dL received in-hospital statin treatment. Statin treatment, compared with no statin treatment, was significantly associated with a reduced risk of the 3-month primary composite outcomes and all-cause death but did not alter the rate of stroke recurrence.
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Collections - 1. Basic Science > Department of Biostatistics > 1. Journal Articles
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