Cumulative Effects of LDL Cholesterol and CRP Levels on Recurrent Stroke and TIA

• Kitagawa Kazuo

  Department of Neurology, Tokyo Women’s Medical University

• Hosomi Naohisa

  Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences

• Nagai Yoji

  Clinical and Translational Research Center, Kobe University Hospital

• Kagimura Tatsuo

  Foundation for Biomedical Research and Innovation at Kobe, Translational Research Center for Medical Innovation

• Ohtsuki Toshiho

  Stroke Center, Kindai University Hospital

• Maruyama Hirofumi

  Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences

• Origasa Hideki

  Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences

• Minematsu Kazuo

  National Cerebral and Cardiovascular Center

• Uchiyama Shinichiro

  Clinical Research Center, International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Medical Center

• Nakamura Masakazu

  National Cerebral and Cardiovascular Center

• Matsumoto Masayasu

  Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences Sakai City Medical Center, Sakai City Hospital Organization

• for the J-STARS collaborators

抄録

Aims: To investigate the relative contribution of on-treatment low-density lipoprotein (LDL) cholesterol and C-reactive protein (CRP) to the risk of recurrent stroke and transient ischemic attack (TIA) in patients with history of ischemic stroke. Methods: A total of 1095 patients with non-cardioembolic ischemic stroke were randomized into two groups: control and patients receiving 10 mg of pravastatin per day. After excluding 18 patients who did not have baseline CRP data, the effects of LDL cholesterol and CRP on recurrent stroke and TIA were prospectively assessed in 1077 patients. Results: During the follow-up of 4.9±1.4 years, there were 131 recurrent stroke or TIA cases. Patients with ontreatment LDL cholesterol ＜120 mg/dL showed 29% reduction in recurrent stroke and TIA than those with LDL cholesterol ≥ 120 mg/dL (event rate 2.20 vs. 3.11 per 100 person-years, hazard ratio [HR] 0.71, 95% confidence interval (CI) 0.50–0.99, p＝0.048). Patients with CRP ＜1 mg/L had 32% reduction compared with that of patients with CRP ≥ 1 mg/L (event rate 2.26 vs. 3.40 per 100 person-years; HR 0.68, 95% CI 0.48–0.96, p＝0.031). Although LDL cholesterol and CRP levels were not correlated in individual patients, those who achieved both LDL cholesterol ＜120 mg/dL and CRP ＜1 mg/L showed 51% reduction compared with that of patients with LDL cholesterol ≥ 120 mg/dL and CRP ≥ 1 mg/L (event rate 2.02 vs. 4.19 per 100 person-years; HR 0.49, 95% CI 0.31–0.79). Conclusions: The control of both LDL cholesterol and CRP levels appears to be effective for preventing recurrent stroke and TIA in patients with non-cardiogenic ischemic stroke.

収録刊行物

• Ｊｏｕｒｎａｌ　ｏｆ　Ａｔｈｅｒｏｓｃｌｅｒｏｓｉｓ　ａｎｄ　Ｔｈｒｏｍｂｏｓｉｓ

  Ｊｏｕｒｎａｌ　ｏｆ　Ａｔｈｅｒｏｓｃｌｅｒｏｓｉｓ　ａｎｄ　Ｔｈｒｏｍｂｏｓｉｓ 26 (5), 432-441, 2019-05-01

  一般社団法人 日本動脈硬化学会

キーワード

• Statin
• Stroke prevention
• Cholesterol
• Crp
• Inflammation

詳細情報

• CRID: 1390282763111647104
• NII論文ID: 130007641195
• DOI: 10.5551/jat.45989
• ISSN: 18803873
• ISSN: 13403478
• HANDLE: 20.500.14094/90005998
• PubMed: 30318492
• Web Site: https://www.jstage.jst.go.jp/article/jat/26/5/26_45989/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2020029201
• 本文言語コード: en
• データソース種別:
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  • IRDB
  • Crossref
  • PubMed
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可