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Association between statin therapy and the risk of stroke in patients with moyamoya disease: a nationwide cohort study

BACKGROUND AND OBJECTIVE: Knowledge regarding the pharmacological treatment for moyamoya disease (MMD), a chronic and progressive cerebrovascular disease conferring greater stroke risk, is limited. In the present study, whether statin therapy is associated with a reduced risk of stroke in patients w...

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Autores principales: Yoo, Joonsang, Jeon, Jimin, Baik, Minyoul, Kim, Jinkwon
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10512045/
https://www.ncbi.nlm.nih.gov/pubmed/36549762
http://dx.doi.org/10.1136/svn-2022-001985
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author Yoo, Joonsang
Jeon, Jimin
Baik, Minyoul
Kim, Jinkwon
author_facet Yoo, Joonsang
Jeon, Jimin
Baik, Minyoul
Kim, Jinkwon
author_sort Yoo, Joonsang
collection PubMed
description BACKGROUND AND OBJECTIVE: Knowledge regarding the pharmacological treatment for moyamoya disease (MMD), a chronic and progressive cerebrovascular disease conferring greater stroke risk, is limited. In the present study, whether statin therapy is associated with a reduced risk of stroke in patients with MMD was investigated. METHODS: This was a retrospective cohort study in which the occurrence of stroke in patients with newly diagnosed MMD was investigated using the nationwide health insurance database in Korea from January 2007 to March 2021. A multivariable Cox proportional hazards regression model was constructed for stroke, in which statin therapy after MMD diagnosis was treated as a time-dependent variable. Adjustment was done for sex, age, presence of comorbidities, concurrent stroke, revascularisation surgery and treatment with antiplatelets. RESULTS: The present study included 13 373 newly diagnosed patients with MMD; 40.8% had a concurrent stroke at the time of MMD diagnosis. During the mean follow-up of 5.1±3.3 years, 631 patients (4.7%) suffered a stroke event (haemorrhagic stroke: 458 patients, ischaemic stroke: 173 patients). Statin therapy after MMD diagnosis was significantly associated with a reduced risk of stroke (adjusted HR 0.74; 95% CI 0.60 to 0.91, p=0.004). In the secondary outcome analysis, the risk of haemorrhagic stroke (adjusted HR 0.74; 95% CI 0.58 to 0.95, p=0.018) and ischaemic stroke (adjusted HR 0.75; 95% CI 0.52 to 1.08, p=0.124) were reduced with the statin treatment. Taking statins was also associated with a lower risk of all-cause mortality (adjusted HR 0.47; 95% CI 0.33 to 0.67, p<0.001). CONCLUSION: In patients with MMD, statin therapy was associated with a reduced risk of subsequent stroke. The findings indicate statin treatment may be beneficial for patients with MMD, however the results should be confirmed in randomised controlled trials.
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spelling pubmed-105120452023-09-22 Association between statin therapy and the risk of stroke in patients with moyamoya disease: a nationwide cohort study Yoo, Joonsang Jeon, Jimin Baik, Minyoul Kim, Jinkwon Stroke Vasc Neurol Original Research BACKGROUND AND OBJECTIVE: Knowledge regarding the pharmacological treatment for moyamoya disease (MMD), a chronic and progressive cerebrovascular disease conferring greater stroke risk, is limited. In the present study, whether statin therapy is associated with a reduced risk of stroke in patients with MMD was investigated. METHODS: This was a retrospective cohort study in which the occurrence of stroke in patients with newly diagnosed MMD was investigated using the nationwide health insurance database in Korea from January 2007 to March 2021. A multivariable Cox proportional hazards regression model was constructed for stroke, in which statin therapy after MMD diagnosis was treated as a time-dependent variable. Adjustment was done for sex, age, presence of comorbidities, concurrent stroke, revascularisation surgery and treatment with antiplatelets. RESULTS: The present study included 13 373 newly diagnosed patients with MMD; 40.8% had a concurrent stroke at the time of MMD diagnosis. During the mean follow-up of 5.1±3.3 years, 631 patients (4.7%) suffered a stroke event (haemorrhagic stroke: 458 patients, ischaemic stroke: 173 patients). Statin therapy after MMD diagnosis was significantly associated with a reduced risk of stroke (adjusted HR 0.74; 95% CI 0.60 to 0.91, p=0.004). In the secondary outcome analysis, the risk of haemorrhagic stroke (adjusted HR 0.74; 95% CI 0.58 to 0.95, p=0.018) and ischaemic stroke (adjusted HR 0.75; 95% CI 0.52 to 1.08, p=0.124) were reduced with the statin treatment. Taking statins was also associated with a lower risk of all-cause mortality (adjusted HR 0.47; 95% CI 0.33 to 0.67, p<0.001). CONCLUSION: In patients with MMD, statin therapy was associated with a reduced risk of subsequent stroke. The findings indicate statin treatment may be beneficial for patients with MMD, however the results should be confirmed in randomised controlled trials. BMJ Publishing Group 2022-12-22 /pmc/articles/PMC10512045/ /pubmed/36549762 http://dx.doi.org/10.1136/svn-2022-001985 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research
Yoo, Joonsang
Jeon, Jimin
Baik, Minyoul
Kim, Jinkwon
Association between statin therapy and the risk of stroke in patients with moyamoya disease: a nationwide cohort study
title Association between statin therapy and the risk of stroke in patients with moyamoya disease: a nationwide cohort study
title_full Association between statin therapy and the risk of stroke in patients with moyamoya disease: a nationwide cohort study
title_fullStr Association between statin therapy and the risk of stroke in patients with moyamoya disease: a nationwide cohort study
title_full_unstemmed Association between statin therapy and the risk of stroke in patients with moyamoya disease: a nationwide cohort study
title_short Association between statin therapy and the risk of stroke in patients with moyamoya disease: a nationwide cohort study
title_sort association between statin therapy and the risk of stroke in patients with moyamoya disease: a nationwide cohort study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10512045/
https://www.ncbi.nlm.nih.gov/pubmed/36549762
http://dx.doi.org/10.1136/svn-2022-001985
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