Statin Treatment in Patients With Stroke With Low-Density Lipoprotein Cholesterol Levels Below 70 mg/dL

Joon Tae Kim, Ji Sung Lee, Beom Joon Kim, Jihoon Kang, Keon Joo Lee, Jong Moo Park, Kyusik Kang, Soo Joo Lee, Jae Guk Kim, Jae Kwan Cha, Dae Hyun Kim, Tai Hwan Park, Kyungbok Lee, Jun Lee, Keun Sik Hong, Yong Jin Cho, Hong Kyun Park, Byung Chul Lee, Kyung Ho Yu, Mi Sun OhDong Eog Kim, Wi Sun Ryu, Jay Chol Choi, Jee Hyun Kwon, Wook Joo Kim, Dong Ick Shin, Kyu Sun Yum, Sung Il Sohn, Jeong Ho Hong, Sang Hwa Lee, Man Seok Park, Kang Ho Choi, Juneyoung Lee, Kwang Yeol Park, Hee Joon Bae

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

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 <70 mg/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 <70 mg/dL and without statin pre-treatment. An inverse probabilities of treatment weights method was applied to control for imbalances in baseline character-istics. The primary outcome was a composite of stroke (either hemorrhagic or ischemic), myocardial infarction, and all-cause death within 3 months. A total of 2850 patients (age, 69.5±13.4 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 3 months 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 <70 mg/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.

Original languageEnglish
Article numbere030738
JournalJournal of the American Heart Association
Volume12
Issue number18
DOIs
StatePublished - 19 Sep 2023

Keywords

  • acute ischemic stroke
  • early vascular outcomes
  • LDL-C
  • statin

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