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Effect of Statin on Stroke Recurrence Prevention at Different Infarction Locations: A Post Hoc Analysis of The J-STARS Study
Aim: Posterior circulation stroke (PCS) has different clinical features and prognosis compared with anterior circulation stroke (ACS), and whether the effect of statin therapy on stroke prevention differs according to infarction location remains unclear. This post hoc analysis of the J-STARS study a...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Japan Atherosclerosis Society
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355099/ https://www.ncbi.nlm.nih.gov/pubmed/31554765 http://dx.doi.org/10.5551/jat.51391 |
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author | Nezu, Tomohisa Hosomi, Naohisa Kitagawa, Kazuo Nagai, Yoji Nakagawa, Yoko Aoki, Shiro Kagimura, Tatsuo Maruyama, Hirofumi Origasa, Hideki Minematsu, Kazuo Uchiyama, Shinichiro Matsumoto, Masayasu |
author_facet | Nezu, Tomohisa Hosomi, Naohisa Kitagawa, Kazuo Nagai, Yoji Nakagawa, Yoko Aoki, Shiro Kagimura, Tatsuo Maruyama, Hirofumi Origasa, Hideki Minematsu, Kazuo Uchiyama, Shinichiro Matsumoto, Masayasu |
author_sort | Nezu, Tomohisa |
collection | PubMed |
description | Aim: Posterior circulation stroke (PCS) has different clinical features and prognosis compared with anterior circulation stroke (ACS), and whether the effect of statin therapy on stroke prevention differs according to infarction location remains unclear. This post hoc analysis of the J-STARS study aimed to compare the usefulness of statin at different infarction locations (i.e., ACS and PCS). Methods: In the J-STARS study, 1578 patients were randomly assigned to the pravastatin or control group. The subjects were divided into two subgroups (ACS and PCS groups) based on the arteries responsible for the infarction. Cox proportional hazards models were used to investigate whether the all stroke recurrence rate was different between the ACS and PCS groups. Results: The PCS group (n = 499) had a significantly higher prevalence of diabetes than the ACS group (n = 1022) (30.7% vs. 19.8%, P < 0.001). During the follow-up (4.9 ± 1.4 years), the incidence of all stroke was significantly lower in the pravastatin group than in the control group among patients with PCS (adjusted hazard ratio [HR] 0.46, 95% confidence interval [CI] 0.25–0.83, P = 0.009); however, the stroke recurrence rates were not significantly different between both groups among patients with ACS (adjusted HR 1.32, 95% CI 0.93–1.88, P = 0.123). A significant interaction between the ACS and PCS groups in terms of pravastatin effects was noted (P = 0.003 for interaction). Conclusions: Pravastatin significantly reduced the recurrence rate of all stroke among patients with PCS. Thus, the effect of statin on the recurrence of stroke may differ according to infarction location. |
format | Online Article Text |
id | pubmed-7355099 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Japan Atherosclerosis Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-73550992020-07-28 Effect of Statin on Stroke Recurrence Prevention at Different Infarction Locations: A Post Hoc Analysis of The J-STARS Study Nezu, Tomohisa Hosomi, Naohisa Kitagawa, Kazuo Nagai, Yoji Nakagawa, Yoko Aoki, Shiro Kagimura, Tatsuo Maruyama, Hirofumi Origasa, Hideki Minematsu, Kazuo Uchiyama, Shinichiro Matsumoto, Masayasu J Atheroscler Thromb Original Article Aim: Posterior circulation stroke (PCS) has different clinical features and prognosis compared with anterior circulation stroke (ACS), and whether the effect of statin therapy on stroke prevention differs according to infarction location remains unclear. This post hoc analysis of the J-STARS study aimed to compare the usefulness of statin at different infarction locations (i.e., ACS and PCS). Methods: In the J-STARS study, 1578 patients were randomly assigned to the pravastatin or control group. The subjects were divided into two subgroups (ACS and PCS groups) based on the arteries responsible for the infarction. Cox proportional hazards models were used to investigate whether the all stroke recurrence rate was different between the ACS and PCS groups. Results: The PCS group (n = 499) had a significantly higher prevalence of diabetes than the ACS group (n = 1022) (30.7% vs. 19.8%, P < 0.001). During the follow-up (4.9 ± 1.4 years), the incidence of all stroke was significantly lower in the pravastatin group than in the control group among patients with PCS (adjusted hazard ratio [HR] 0.46, 95% confidence interval [CI] 0.25–0.83, P = 0.009); however, the stroke recurrence rates were not significantly different between both groups among patients with ACS (adjusted HR 1.32, 95% CI 0.93–1.88, P = 0.123). A significant interaction between the ACS and PCS groups in terms of pravastatin effects was noted (P = 0.003 for interaction). Conclusions: Pravastatin significantly reduced the recurrence rate of all stroke among patients with PCS. Thus, the effect of statin on the recurrence of stroke may differ according to infarction location. Japan Atherosclerosis Society 2020-06-01 /pmc/articles/PMC7355099/ /pubmed/31554765 http://dx.doi.org/10.5551/jat.51391 Text en 2020 Japan Atherosclerosis Society This article is distributed under the terms of the latest version of CC BY-NC-SA defined by the Creative Commons Attribution License.http://creativecommons.org/licenses/by-nc-sa/3.0/ |
spellingShingle | Original Article Nezu, Tomohisa Hosomi, Naohisa Kitagawa, Kazuo Nagai, Yoji Nakagawa, Yoko Aoki, Shiro Kagimura, Tatsuo Maruyama, Hirofumi Origasa, Hideki Minematsu, Kazuo Uchiyama, Shinichiro Matsumoto, Masayasu Effect of Statin on Stroke Recurrence Prevention at Different Infarction Locations: A Post Hoc Analysis of The J-STARS Study |
title | Effect of Statin on Stroke Recurrence Prevention at Different Infarction Locations: A Post Hoc Analysis of The J-STARS Study |
title_full | Effect of Statin on Stroke Recurrence Prevention at Different Infarction Locations: A Post Hoc Analysis of The J-STARS Study |
title_fullStr | Effect of Statin on Stroke Recurrence Prevention at Different Infarction Locations: A Post Hoc Analysis of The J-STARS Study |
title_full_unstemmed | Effect of Statin on Stroke Recurrence Prevention at Different Infarction Locations: A Post Hoc Analysis of The J-STARS Study |
title_short | Effect of Statin on Stroke Recurrence Prevention at Different Infarction Locations: A Post Hoc Analysis of The J-STARS Study |
title_sort | effect of statin on stroke recurrence prevention at different infarction locations: a post hoc analysis of the j-stars study |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355099/ https://www.ncbi.nlm.nih.gov/pubmed/31554765 http://dx.doi.org/10.5551/jat.51391 |
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