Different Influences of Statin Treatment in Preventing At-Risk Stroke Subtypes: A Post Hoc Analysis of J-STARS

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Author(s)

    • Hosomi Naohisa
    • Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
    • Uchiyama Shinichiro
    • Clinical Research Center, International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical 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
    • Kitagawa Kazuo
    • Department of Neurology, Tokyo Women's Medical University School of Medicine
    • Nagai Yoji
    • Center for Clinical Research, Kobe University Hospital
    • Nakagawa Yoko
    • Division of Medical Statistics, Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe
    • Aoki Shiro
    • Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
    • Nezu Tomohisa
    • Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences
    • Kagimura Tatsuo
    • Division of Medical Statistics, Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe
    • 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

Abstract

<p><b>Aims: </b>To understand the different influences of statins on the incidence rate of each stroke subtype in association with low-density lipoprotein (LDL) cholesterol levels, we performed a post hoc analysis on the data from the Japan Statin Treatment Against Recurrent Stroke (J-STARS) study.<b> </b></p><p><b>Methods: </b>Subjects (<i>n</i>=1,578) were divided into three groups according to their mean postrandomized LDL cholesterol level (<100, 100–120, and ≥ 120 mg/dL) until the last observation before the event or the end of follow-up. A Cox proportional hazard model for time to events was used for calculating adjusted hazard ratios, 95% confidence intervals, and the trend tests.<b> </b></p><p><b>Results: </b>The event rates for atherothrombotic stroke did not decrease in accordance with the postrandomized LDL cholesterol level subgroups of either the control or the pravastatin group (<i>p</i>=0.15 and 0.33 for the trend, respectively). In the control group, however, no atherothrombotic stroke event was observed in the subgroup of the low postrandomized LDL cholesterol level (less than 100 mg/dL). The event rates for atherothrombotic stroke were lower in the middle postrandomized LDL cholesterol level subgroup (100–120 mg/dL) of the pravastatin group than that of the control group. The event rates for lacunar stroke decreased in the lower postrandomized LDL cholesterol level subgroup of the control group but not of the pravastatin group (<i>p</i>=0.004 and 0.06 for the trend, respectively).<b> </b></p><p><b>Conclusions: </b>Statins showed different influences on the risks of atherothromobotic and lacunar stroke according to postrandomized LDL cholesterol levels.</p>

Journal

  • Journal of Atherosclerosis and Thrombosis

    Journal of Atherosclerosis and Thrombosis, 2019

    Japan Atherosclerosis Society

Codes

  • NII Article ID (NAID)
    130007708816
  • Text Lang
    ENG
  • ISSN
    1340-3478
  • Data Source
    J-STAGE 
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