Admission LDL-cholesterol, statin pretreatment and early outcomes in acute ischemic stroke
- 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
- ELSEVIER SCIENCE INC
- Keywords
- Lipid paradox; LDL-cholesterol; Acute ischemic stroke; Early vascular outcome; Statin pretreatment
- Citation
- Journal of Clinical Lipidology, v.17, no.5, pp 612 - 621
- Pages
- 10
- Indexed
- SCIE
SCOPUS
- Journal Title
- Journal of Clinical Lipidology
- Volume
- 17
- Number
- 5
- Start Page
- 612
- End Page
- 621
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/65240
- DOI
- 10.1016/j.jacl.2023.08.002
- ISSN
- 1933-2874
1876-4789
- Abstract
- Background: Lipid paradox of low LDL-C may cause physicians to be reluctant to use statins in acute ischemic stroke (AIS) patients with low LDL-C levels at admission. Objective: This study investigated the association between LDL-C levels and early vascular outcomes and assessed the potential interaction effect between LDL-C and statin pretreatment on early outcomes.Patients and methods: This was a study of a prospective, multicenter, registry of AIS patients with admission LDL-C. The subjects were divided into 3 groups according to LDL-C levels: low LDL-C (<= 100 mg/dL); intermediate LDL-C ( > 100, < 130 mg/dL); and high LDL-C (>= 130 mg/dL). The primary early vascular outcome was a composite of stroke (ischemic or hemorrhagic), myocardial infarction and all-cause mortality within 3 months. The associations of LDL-C levels as a continuous variable and the risks of primary outcome using Cox proportional hazards models with restricted cubic splines were explored.Results: A total of 32,505 patients (age, 69 +/- 12; male, 58.6%) were analyzed. The 3 groups showed significant differences in the 3-month primary outcome, with highest events in the low LDLC group; after adjustment, no significant associations with the 3-month primary outcome remained. U-shaped nonlinear relationships of LDL-C levels with the 3-month primary outcome were observed (Pnon-linearity < 0.001), with substantial relationships in the no pretreatment subgroup.Conclusions: The relationships between admission LDL-C levels and early outcomes are complex but appear to be paradoxical in patients with low LDL-C and no statin pretreatment. The results suggest that statin pretreatment might offset the paradoxical response of low LDL-C on early vascular outcomes. Further study would be warranted.(c) 2023 National Lipid Association. Published by Elsevier Inc. All rights reserved.
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Collections - 1. Basic Science > Department of Biostatistics > 1. Journal Articles
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