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Effect of in-hospital initiation of lipid-lowering therapy on six-month outcomes in patients with acute ischemic stroke or transient ischemic attack.
Am J Cardiol. 2010 May 15; 105(10):1490-4.AJ

Abstract

Early lipid-lowering therapy (LLT) has demonstrated clinical benefits in patients with acute coronary syndrome; however, little is known about early LLT in patients with stroke. We evaluated the effect of in-hospital initiation of LLT on the clinical outcomes of patients with stroke. The Taiwan Stroke Registry prospectively collected data from patients with acute ischemic stroke or transient ischemic attack. By July 31, 2008, 16,704 adult patients without previous LLT had been admitted and survived to discharge. The study end point was the composite outcome of recurrent stroke, ischemic heart disease, and all-cause death. We examined the effect of LLT at discharge on the clinical outcomes of these patients. A propensity analysis was done to adjust for selection biases in the prescription of LLT. At discharge, 4,032 patients (24%) had received LLT. At 6 months, 206 patients (5.1%) in the LLT group and 964 patients (7.6%) in the non-LLT group had developed > or =1 component of the composite end point (p <0.0001). On multivariate Cox regression analysis, after adjustment for the potential confounders, LLT use at discharge was associated with a lower rate of the composite end point at 6 months (hazard ratio 0.78, 95% confidence interval 0.61 to 0.98, p = 0.013). In conclusion, our data have indicated that LLT has been underused in patients with stroke. In-hospital initiation of LLT was associated with a better clinical outcome in patients with ischemic stroke or transient ischemic attack.

Authors+Show Affiliations

Department of Neurology, Chi-Mei Medical Center, Tainan, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20451701

Citation

Yeh, Poh-Shiow, et al. "Effect of In-hospital Initiation of Lipid-lowering Therapy On Six-month Outcomes in Patients With Acute Ischemic Stroke or Transient Ischemic Attack." The American Journal of Cardiology, vol. 105, no. 10, 2010, pp. 1490-4.
Yeh PS, Lin HJ, Bai CH, et al. Effect of in-hospital initiation of lipid-lowering therapy on six-month outcomes in patients with acute ischemic stroke or transient ischemic attack. Am J Cardiol. 2010;105(10):1490-4.
Yeh, P. S., Lin, H. J., Bai, C. H., Hsieh, F. I., Ke, D. S., & Li, Y. H. (2010). Effect of in-hospital initiation of lipid-lowering therapy on six-month outcomes in patients with acute ischemic stroke or transient ischemic attack. The American Journal of Cardiology, 105(10), 1490-4. https://doi.org/10.1016/j.amjcard.2009.07.065
Yeh PS, et al. Effect of In-hospital Initiation of Lipid-lowering Therapy On Six-month Outcomes in Patients With Acute Ischemic Stroke or Transient Ischemic Attack. Am J Cardiol. 2010 May 15;105(10):1490-4. PubMed PMID: 20451701.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of in-hospital initiation of lipid-lowering therapy on six-month outcomes in patients with acute ischemic stroke or transient ischemic attack. AU - Yeh,Poh-Shiow, AU - Lin,Huey-Juan, AU - Bai,Chyi-Huey, AU - Hsieh,Fang-I, AU - Ke,Der-Shin, AU - Li,Yi-Heng, AU - ,, Y1 - 2010/03/30/ PY - 2009/05/30/received PY - 2009/07/14/revised PY - 2009/07/14/accepted PY - 2010/5/11/entrez PY - 2010/5/11/pubmed PY - 2010/6/2/medline SP - 1490 EP - 4 JF - The American journal of cardiology JO - Am J Cardiol VL - 105 IS - 10 N2 - Early lipid-lowering therapy (LLT) has demonstrated clinical benefits in patients with acute coronary syndrome; however, little is known about early LLT in patients with stroke. We evaluated the effect of in-hospital initiation of LLT on the clinical outcomes of patients with stroke. The Taiwan Stroke Registry prospectively collected data from patients with acute ischemic stroke or transient ischemic attack. By July 31, 2008, 16,704 adult patients without previous LLT had been admitted and survived to discharge. The study end point was the composite outcome of recurrent stroke, ischemic heart disease, and all-cause death. We examined the effect of LLT at discharge on the clinical outcomes of these patients. A propensity analysis was done to adjust for selection biases in the prescription of LLT. At discharge, 4,032 patients (24%) had received LLT. At 6 months, 206 patients (5.1%) in the LLT group and 964 patients (7.6%) in the non-LLT group had developed > or =1 component of the composite end point (p <0.0001). On multivariate Cox regression analysis, after adjustment for the potential confounders, LLT use at discharge was associated with a lower rate of the composite end point at 6 months (hazard ratio 0.78, 95% confidence interval 0.61 to 0.98, p = 0.013). In conclusion, our data have indicated that LLT has been underused in patients with stroke. In-hospital initiation of LLT was associated with a better clinical outcome in patients with ischemic stroke or transient ischemic attack. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/20451701/Effect_of_in_hospital_initiation_of_lipid_lowering_therapy_on_six_month_outcomes_in_patients_with_acute_ischemic_stroke_or_transient_ischemic_attack_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(10)00090-1 DB - PRIME DP - Unbound Medicine ER -