Statin therapy after first stroke reduces 10-year stroke recurrence and improves survival
Statin therapy after first stroke reduces 10-year stroke recurrence and improves survival
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DOI：
10.1212/wnl.0b013e3181a711cb
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发表时间：
2009-05-26
期刊：
影响因子：
9.9
通讯作者：
Vemmos, K.
中科院分区：
文献类型：
--
作者：
Milionis, H. J.;Giannopoulos, S.;Vemmos, K.
目的：确定出院后他汀类药物治疗是否影响首次发生缺血性stroke.Methods的患者的缺血性卒中复发和长期死亡率：这是一项回顾性观察研究，涉及相关的住院和死亡记录。该队列包括来自雅典卒中登记处的794例连续的首次急性缺血性卒中患者，自1997年1月以来入住我们机构的急性卒中单元和普通内科和神经内科病房，有涵盖10年随访期的可用信息。考克斯比例风险模型被用来确定中风复发和death.Results的危险因素：复发率为16.3%，中风患者出院后未接受他汀类药物治疗，而那些谁接受他汀类药物治疗的7.5%（P = 0.002）。考克斯回归分析显示，只有出院后他汀类药物治疗是卒中复发的重要独立预测因子（校正风险比[HR]，0.65，95%置信区间[CI] 0.39 - 0.97，p < 0.01）。同样，接受他汀类药物治疗的患者在急性脑血管事件发生后10年内的死亡率显著降低（校正HR，0.43; 95%CI 0.29至0.61，p < 0.01）。结论：首次急性卒中患者出院后给予他汀类药物治疗可降低10年卒中复发的风险，提高生存率。神经病学（R）2009; 72：1816-1822
Objective: To determine whether statin therapy after hospital discharge affects ischemic stroke recurrence and long-term mortality in patients admitted for a first-ever occurrence of ischemic stroke.Methods: This was a retrospective observational study involving linked hospitalization and death records. The cohort comprised a series of 794 consecutive, first-ever acute ischemic stroke patients from the Athenian Stroke Registry, admitted to the acute stroke unit and the general medicine and neurology ward of our institutions since January 1997 for whom there was available information covering a 10-year follow-up period. Cox proportional hazards model was used to identify risk factors for stroke recurrence and death.Results: The recurrence rate was 16.3% among stroke patients not receiving a statin after hospital discharge compared with 7.5% among those who received statin therapy (p = 0.002). Cox regression analyses revealed only statin therapy postdischarge to be a significant independent predictor of stroke recurrence (adjusted hazard ratio [HR], 0.65, 95% confidence interval [CI] 0.39 to 0.97, p < 0.01). Similarly, patients receiving a statin had a significantly lower mortality during the 10-year period after the acute cerebrovascular event (adjusted HR, 0.43; 95% CI 0.29 to 0.61, p < 0.01).Conclusions: Prescribing statin therapy upon hospital discharge to patients with first-ever acute stroke lowers the risk of 10-year stroke recurrence and improves survival. Neurology (R) 2009; 72: 1816-1822