In-hospital statin treatment significantly reduced the 3-month risk of stroke, myocardial infarction, or death compared with no statin (weighted HR 0.54; 95% CI 0.42-0.69) in patients with LDL-C <70 mg/dL.
Observational (n=2,850)
Yes
Does in-hospital statin treatment reduce the composite of stroke, myocardial infarction, and all-cause death in patients with first-ever acute ischemic stroke and baseline LDL-C <70 mg/dL?
In-hospital statin treatment in patients with first-ever acute ischemic stroke and baseline LDL-C <70 mg/dL is associated with a significantly reduced risk of a 3-month composite of stroke, MI, and all-cause death.
Effect estimate: weighted HR 0.54 (95% CI 0.42-0.69)
Absolute Event Rate: 6.7% vs 21.5%
p-value: p=<0.001
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 pretreatment. An inverse probabilities of treatment weights method was applied to control for imbalances in baseline characteristics. 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.
Kim et al. (Fri,) conducted a observational in First-ever acute ischemic stroke with baseline LDL-C <70 mg/dL (n=2,850). In-hospital statin treatment vs. No statin treatment was evaluated on Composite of stroke (either hemorrhagic or ischemic), myocardial infarction, and all-cause death within 3 months (weighted HR 0.54, 95% CI 0.42-0.69, p=<0.001). In-hospital statin treatment significantly reduced the 3-month risk of stroke, myocardial infarction, or death compared with no statin (weighted HR 0.54; 95% CI 0.42-0.69) in patients with LDL-C <70 mg/dL.
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