Statin-based therapy for primary and secondary prevention of ischemic stroke: A meta-analysis and critical overview
dc.creator | Milionis H., Ntaios G., Korompoki E., Vemmos K., Michel P. | en |
dc.date.accessioned | 2023-01-31T09:00:06Z | |
dc.date.available | 2023-01-31T09:00:06Z | |
dc.date.issued | 2020 | |
dc.identifier | 10.1177/1747493019873594 | |
dc.identifier.issn | 17474930 | |
dc.identifier.uri | http://hdl.handle.net/11615/76638 | |
dc.description.abstract | Background and aims: To reassess the effect of statin-based lipid-lowering therapy on ischemic stroke in primary and secondary prevention trials with regard to achieved levels of low-density lipoprotein-cholesterol in view of the availability of novel potent hypolipidemic agents. Methods: English literature was searched (up to November 2018) for publications restricted to trials with a minimum enrolment of 1000 and 500 subjects for primary and secondary prevention, respectively, meeting the following criteria: adult population, randomized controlled design, and recorded outcome data on ischemic stroke events. Data were meta-analyzed and curve-estimation procedure was applied to estimate regression statistics and produce related plots. Results: Four primary prevention trials and four secondary prevention trials fulfilled the eligibility criteria. Lipid-lowering therapy was associated with a lower risk of ischemic stroke in primary (risk ratio, RR 0.70, 95% confidence interval, CI, 0.60–0.82; p < 0.001) and in the secondary prevention setting (RR 0.80, 95% CI 0.70–0.90; p < 0.001). Curve-estimation procedure revealed a linear relationship between the absolute risk reduction of ischemic stroke and active treatment-achieved low-density lipoprotein-cholesterol levels in secondary prevention (adjusted R-square 0.90) in support of “the lower the better” hypothesis for stroke survivors. On the other hand, the cubic model followed the observed data well in primary prevention (adjusted R-square 0.98), indicating greater absolute risk reduction in high-risk cardiovascular disease-free individuals. Conclusions: Statin-based lipid-lowering is effective both for primary and secondary prevention of ischemic stroke. Most benefit derives from targeting disease-free individuals at high cardiovascular risk, and by achieving low treatment targets for low-density lipoprotein-cholesterol in stroke survivors. © 2019 World Stroke Organization. | en |
dc.language.iso | en | en |
dc.source | International Journal of Stroke | en |
dc.source.uri | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85073972270&doi=10.1177%2f1747493019873594&partnerID=40&md5=137ea9b8a9e7675b435d3adcd4dfabb2 | |
dc.subject | atorvastatin | en |
dc.subject | ezetimibe plus simvastatin | en |
dc.subject | hydroxymethylglutaryl coenzyme A reductase inhibitor | en |
dc.subject | low density lipoprotein cholesterol | en |
dc.subject | pravastatin | en |
dc.subject | rosuvastatin | en |
dc.subject | simvastatin | en |
dc.subject | brain ischemia | en |
dc.subject | cardiovascular disease | en |
dc.subject | cholesterol blood level | en |
dc.subject | human | en |
dc.subject | meta analysis | en |
dc.subject | primary prevention | en |
dc.subject | priority journal | en |
dc.subject | Review | en |
dc.subject | risk reduction | en |
dc.subject | secondary prevention | en |
dc.subject | stroke patient | en |
dc.subject | stroke survivor | en |
dc.subject | systematic review | en |
dc.subject | adult | en |
dc.subject | brain ischemia | en |
dc.subject | cerebrovascular accident | en |
dc.subject | complication | en |
dc.subject | primary prevention | en |
dc.subject | secondary prevention | en |
dc.subject | Adult | en |
dc.subject | Brain Ischemia | en |
dc.subject | Humans | en |
dc.subject | Hydroxymethylglutaryl-CoA Reductase Inhibitors | en |
dc.subject | Ischemic Stroke | en |
dc.subject | Primary Prevention | en |
dc.subject | Secondary Prevention | en |
dc.subject | Stroke | en |
dc.subject | SAGE Publications Inc. | en |
dc.title | Statin-based therapy for primary and secondary prevention of ischemic stroke: A meta-analysis and critical overview | en |
dc.type | other | en |
Αρχεία σε αυτό το τεκμήριο
Αρχεία | Μέγεθος | Τύπος | Προβολή |
---|---|---|---|
Δεν υπάρχουν αρχεία που να σχετίζονται με αυτό το τεκμήριο. |