国家神经系统疾病临床医学研究中心数据管理与共享系统

Data Management And Sharing System of China National Clinical Research Center for Neurological Diseases

《国家中心数据管理与共享系统操作说明书 —— 研究者部分》

LDL-C levels, lipid-lowering treatment and recurrent stroke in minor ischaemic stroke or TIA

第一作者：Yuesong Pan,Runqi Wangqin

通讯作者：Yongjun Wang

LDL-C lipid-lowering minor ischaemic stroke TIA

基本信息

2022-03-07

已发表文章

发表杂志：Stroke and Vascular Neurology

发表类型: Article

影响因子(IF): 9.893

PMID: 35256525 Pubmed原文链接 全文下载

主要研究背景及目的

Numerous previous epidemiological studies and randomized trials have established the association of elevated LDL-C level with risk of and poor outcome of cardiovascular diseases. Whereas, previous studies on stroke mainly focused on the association of LDL-C and risk of ischemic stroke in the primary prevention setting. Few studies described the pattern and magnitude of the association between LDL-C level and the short-term prognosis of minor stroke and transient ischemic attack (TIA). This study thus aimed to evaluate the pattern and magnitude of association between baseline LDL-C level and short-term prognosis of patients with acute minor ischemic stroke or TIA.

方法

We derived data from the Clopidogrel in High-risk patients with Acute Non-disabling Cerebrovascular Events trial. Patients with a minor stroke or TIA were categorised by LDL-C level at baseline (<2.6 or ≥2.6 mmol/L (100 mg/dL)) and with or without lipid-lowering treatment after symptom onset. The primary outcome was a new ischaemic stroke at 3 months. The association of baseline LDL-C level, lowering treatment and outcomes were assessed.

结论

Elevated untreated baseline LDL-C level was associated with an increased short-term risk of ischaemic stroke among patients presenting with minor ischaemic stroke or TIA. There was potential benefit of lipid-lowering treatment in minor stroke or TIA patients with LDL-C ≥2.6 mmol/L.

主要结果

Among 3027 patients, 2154 (71.2%) patients had an initial LDL-C ≥2.6 mmol/L, of which 1267 (41.9%) received lipid-lowering treatment. Elevated LDL-C level was associated with a higher risk of new ischaemic stroke at 3 months in patients without lipid-lowering treatment (adj.HR=1.35, 95% CI: 1.19 to 1.53), but not in those with lipid-lowering treatment (adj.HR=0.99, 95% CI: 0.82 to 1.19) (p for interaction=0.007). Patients with LDL-C ≥2.6 mmol/L had a numerically higher risk of ischaemic stroke (11.8% vs 8.0%, adj.HR=1.37, 95% CI: 0.96 to 1.96) in those without lipid-lowering treatment. For patients with LDL-C ≥2.6 mmol/L, lipid-lowering treatment was associated with reduced risk of ischaemic stroke at 3 months (7.9% vs 11.8%; adj.HR=0.54, 95% CI: 0.39 to 0.75).