Naohisa Hosomi1, Kazuo Kitagawa2, Yoji Nagai3, Yoko Nakagawa4, Shiro Aoki1, Tomohisa Nezu1, Tatsuo Kagimura4, Hirofumi Maruyama1, Hideki Origasa5, Kazuo Minematsu6, Shinichiro Uchiyama7, Masayasu Matsumoto1,8. 1. Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences. 2. Department of Neurology, Tokyo Women's Medical University School of Medicine. 3. Center for Clinical Research, Kobe University Hospital. 4. Division of Medical Statistics, Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation at Kobe. 5. Division of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences. 6. National Cerebral and Cardiovascular Center. 7. Clinical Research Center, International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center. 8. Sakai City Medical Center, Sakai City Hospital Organization.
Abstract
AIMS: 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. METHODS: Subjects (n=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. RESULTS: 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 (p=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 (p=0.004 and 0.06 for the trend, respectively). CONCLUSIONS: Statins showed different influences on the risks of atherothromobotic and lacunar stroke according to postrandomized LDL cholesterol levels.
RCT Entities:
AIMS: 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. METHODS: Subjects (n=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. RESULTS: 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 (p=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 (p=0.004 and 0.06 for the trend, respectively). CONCLUSIONS: Statins showed different influences on the risks of atherothromobotic and lacunar stroke according to postrandomized LDL cholesterol levels.
Authors: L B Goldstein; P Amarenco; M Szarek; A Callahan; M Hennerici; H Sillesen; J A Zivin; K M A Welch Journal: Neurology Date: 2007-12-12 Impact factor: 9.910
Authors: Pierre Amarenco; Larry B Goldstein; Michael Szarek; Henrik Sillesen; Amy E Rudolph; Alfred Callahan; Michael Hennerici; Lisa Simunovic; Justin A Zivin; K Michael A Welch Journal: Stroke Date: 2007-10-25 Impact factor: 7.914
Authors: Henrik Sillesen; Pierre Amarenco; Michael G Hennerici; Alfred Callahan; Larry B Goldstein; Justin Zivin; Michael Messig; K Michael Welch Journal: Stroke Date: 2008-10-09 Impact factor: 7.914