Journal of Medicine and Life Science

Institute for Medical Science (제주대학교 의과학연구소)
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Effectiveness of statin treatment for recurrent stroke according to stroke subtypes

뇌졸중 재발에 대한 스타틴 치료의 뇌졸중 아형에 따른 효과성

  • Min-Surk Kye (Department of Neurology, Seongnam Citizens Medical Center) ;
  • Do Yeon Kim (Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital) ;
  • Dong-Wan Kang (Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital) ;
  • Baik Kyun Kim (Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital) ;
  • Jung Hyun Park (Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital) ;
  • Hyung Seok Guk (Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital) ;
  • Nakhoon Kim (Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital) ;
  • Sang-Won Choi (Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital) ;
  • Dongje Lee (Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital) ;
  • Yoona Ko (Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital) ;
  • Jun Yup Kim (Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital) ;
  • Jihoon Kang (Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital) ;
  • Beom Joon Kim (Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital) ;
  • Moon-Ku Han (Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital) ;
  • Hee-Joon Bae (Department of Neurology and Cerebrovascular Center, Seoul National University Bundang Hospital)
  • 계민석 (성남시의료원 신경과) ;
  • 김도연 (분당서울대학교병원 신경과 및 뇌혈관센터) ;
  • 강동완 (분당서울대학교병원 신경과 및 뇌혈관센터) ;
  • 김백균 (분당서울대학교병원 신경과 및 뇌혈관센터) ;
  • 박정현 (분당서울대학교병원 신경과 및 뇌혈관센터) ;
  • 국형석 (분당서울대학교병원 신경과 및 뇌혈관센터) ;
  • 김낙훈 (분당서울대학교병원 신경과 및 뇌혈관센터) ;
  • 최상원 (분당서울대학교병원 신경과 및 뇌혈관센터) ;
  • 이동제 (분당서울대학교병원 신경과 및 뇌혈관센터) ;
  • 고윤아 (분당서울대학교병원 신경과 및 뇌혈관센터) ;
  • 김준엽 (분당서울대학교병원 신경과 및 뇌혈관센터) ;
  • 강지훈 (분당서울대학교병원 신경과 및 뇌혈관센터) ;
  • 김범준 (분당서울대학교병원 신경과 및 뇌혈관센터) ;
  • 한문구 (분당서울대학교병원 신경과 및 뇌혈관센터) ;
  • 배희준 (분당서울대학교병원 신경과 및 뇌혈관센터)
  • Received : 2024.02.26
  • Accepted : 2024.03.13
  • Published : 2024.05.31
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Abstract

Understanding the effectiveness of statin treatment is essential for developing tailored stroke prevention strategies. We aimed to evaluate the efficacy of statin treatment in preventing recurrent stroke among patients with various ischemic stroke subtypes. Using data from the Clinical Research Collaboration for Stroke-Korea-National Institute for Health (CRCS-K-NIH) registry, we included patients with acute ischemic stroke admitted between January 2011 and July 2020. To evaluate the differential effects of statin treatment based on the ischemic stroke subtype, we analyzed patients with large artery atherosclerosis (LAA), cardio-embolism (CE), and small vessel occlusion (SVO). The primary outcomes were recurrent ischemic stroke and recurrent stroke events. The hazard ratio for outcomes between statin users and nonusers was compared using a Cox proportional hazards model adjusted for covariates. A total of 46,630 patients who met the inclusion criteria were analyzed. Statins were prescribed to 92%, 93%, and 78% of patients with LAA, SVO, and CE subtypes, respectively. The hazards of recurrent ischemic stroke and recurrent stroke in statin users were reduced to 0.79 (95% confidence interval [CI], 0.63-0.99) and 0.77 (95% CI, 0.62-0.95) in the LAA subtype and 0.63 (95% CI, 0.52-0.76) and 0.63 (95% CI, 0.53-0.75) in CE subtype compared to nonusers. However, the hazards of these outcomes did not significantly decrease in the SVO subtype. The effectiveness of statin treatment in reducing the risk of recurrent stroke in patients with LAA and CE subtypes has been suggested. Nonetheless, no significant effect was observed in the SVO subtype, suggesting a differential effect of statins on different stroke subtypes.

Keywords

Acknowledgement

This research was supported by a fund (2023-ER1006-00) by Research of Korea Centers for Disease Control and Prevention. We are grateful to the institutions that afforded us the chance to utilize the Clinical Research Collaboration for Stroke in Korea (CRCS-K) databases for our research.

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