Intensive Versus Moderate Statin‐Based Therapies in Patients With Mild Ischemic Stroke: A Prospective Multicenter Cohort Study

作者：Haimei Fan, Yongle Wang, Kaili Zhang, Ting‐ting Liu, Xinyi Li, Yanan Li, Yali Li, Juan Li, Jing Ren, Yuting Liu, Junhui Wang, Lixi Xue, Wenxian Du, Wenhua Niu, Yuping Yan, Xiaolei Gao, Qingping Liu, Gaimei Li, Xuemei Wu, Xiaoyuan Niu · 发表于：Journal of the American Heart Association · 年份：2024 · DOI：10.1161/jaha.124.035337 · 被引用次数：10 · 研究领域：Lipoproteins and Cardiovascular Health、Acute Ischemic Stroke Management、Cerebrovascular and Carotid Artery Diseases

Background Statins are widely used for treating patients with ischemic stroke at risk of secondary cerebrovascular events. It is unknown whether Asian populations benefit from more intensive statin‐based therapy for stroke recurrence. Therefore, in the present study we evaluated the effectiveness and safety of high‐dose and moderate‐dose statins for patients who had experienced mild ischemic stroke during the acute period. Methods and Results This multicenter prospective study included patients with mild ischemic stroke who presented within 72 hours of symptom onset. The outcomes of patients in the high‐intensity and moderate‐intensity statin treatment groups were compared, with the main efficacy outcome being stroke recurrence and the primary safety end point being intracranial hemorrhage. The propensity score matching method was employed to control for imbalances in baseline variables. Subgroup analyses were conducted to evaluate group differences. In total, the data of 2950 patients were analyzed at 3 months, and the data of 2764 patients were analyzed at 12 months due to loss to follow‐up. According to the multivariable Cox analyses adjusted for potential confounders, stroke recurrence occurred similarly in the high‐intensity statin and moderate‐intensity statin groups (3 months: adjusted hazard ratio [HR], 1.12 [95% CI, 0.85–1.49]; P =0.424; 12 months: adjusted HR, 1.08 [95% CI, 0.86–1.34]; P =0.519). High‐intensity statin therapy was associated with an increased risk of...