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ID 48648
file
creator
Nagai, Yoji
Kohriyama, Tatsuo
Ohtsuki, Toshiho
Aoki, Shiro
Sunami, Norio
Yokota, Chiaki
Kitagawa, Kazuo
Terayama, Yasuo
Takagi, Makoto
Ibayashi, Setsuro
Nakamura, Masakazu
Origasa, Hideki
Fukushima, Masanori
Mori, Etsuro
Minematsu, Kazuo
Uchiyama, Shinichiro
Shinohara, Yukito
Yamaguchi, Takenori
subject
Statin
Ischemic stroke
Hemorrhagic stroke
Atherothrombotic infarction
Cholesterol
abstract
Background: Although statin therapy is beneficial for the prevention of initial stroke, the benefit for recurrent stroke and its subtypes remains to be determined in Asian, in whom stroke profiles are different from Caucasian. This study examined whether treatment with low-dose pravastatin prevents stroke recurrence in ischemic stroke patients.
Methods: This is a multicenter, randomized, open-label, blinded-endpoint, parallel-group study of patients who experienced non-cardioembolic ischemic stroke. All patients had a total cholesterol level between 4.65 and 6.21 mmol/L at enrollment, without the use of statins. The pravastatin group patients received 10 mg of pravastatin/day; the control group patients received no statins. The primary endpoint was the occurrence of stroke and transient ischemic attack (TIA), with the onset of each stroke subtype set to be one of the secondary endpoints.
Finding: Although 3000 patients were targeted, 1578 patients (491 female, age 66.2 years) were recruited and randomly assigned to pravastatin group or control group. During the follow-up of 4.9 ± 1.4 years, although total stroke and TIA similarly occurred in both groups (2.56 vs. 2.65%/year), onset of atherothrombotic infarction was less frequent in pravastatin group (0.21 vs. 0.64%/year, p = 0.0047, adjusted hazard ratio 0.33 [95%CI 0.15 to 0.74]). No significant intergroup difference was found for the onset of other stroke subtypes, and for the occurrence of adverse events.
Interpretation: Although whether low-dose pravastatin prevents recurrence of total stroke or TIA still needs to be examined in Asian, this study has generated a hypothesis that it may reduce occurrence of stroke due to larger artery atherosclerosis.
Funding: This study was initially supported by a grant from the Ministry of Health, Labour and Welfare, Japan. After the governmental support expired, it was conducted in collaboration between Hiroshima University and the Foundation for Biomedical Research and Innovation.
journal title
EBioMedicine
volume
Volume 2
issue
Issue 9
start page
1071
end page
1078
date of issued
2015-08
publisher
Elsevier B.V.
issn
2352-3964
publisher doi
pubmed id
language
eng
nii type
Journal Article
HU type
Journal Articles
DCMI type
text
format
application/pdf
text version
publisher
rights
Copyright © 2015 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
relation url
department
Graduate School of Biomedical & Health Sciences