The Effect of Statin Treatment on Outcomes of Cardioembolic Stroke: A Systematic Review and Meta-Analysis of Real-World Studies
The Effect of Statin Treatment on Outcomes of Cardioembolic Stroke: A Systematic Review and Meta-Analysis of Real-World Studies
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他汀类药物治疗对心源性中风结局的影响：现实世界研究的系统回顾和荟萃分析。
DOI：
10.1007/s40263-021-00829-6
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发表时间：
2021-05
期刊：
影响因子：
6
通讯作者：
Chen Yangmei
中科院分区：
文献类型：
--
作者：
Xu Tao;Wang You;Yuan Jinxian;Chen Yangmei
背景几项真实世界的观察性研究已经调查了他汀类药物治疗与心源性卒中预后的关系。我们的目标是进行系统的综述和荟萃分析，以确定他汀类药物治疗对心源性卒中预后的影响。方法我们系统地搜索PubMed和Embase数据库中的相关临床研究。采用合并相对危险度(RR)和95%可信区间(CI)结合随机效应模型对研究结果进行评估。未发现随机临床试验。与非他汀类药物治疗相比，他汀类药物治疗并不能降低心源性卒中患者中风复发的风险(RR，0.93；95%CI 0.82-1.06)。然而，与非他汀类药物治疗相比，在PWCS中，他汀类药物治疗的全因死亡风险较低(RR，0.59；95%CI为0.49-0.73)，而功能预后较好(RR，0.67；95%CI为0.47-0.97)。他汀类药物治疗与PWCS的主要出血事件风险之间没有显著关联(RR，0.35；95%CI 0.06-2.16)。与非他汀类药物治疗相比，他汀类药物治疗并未降低PWCS患者冠状动脉粥样硬化的风险(RR，1.04；95%CI为0.96~1.11)。结论尽管他汀类药物的应用不能加强PWCS患者卒中复发的预防，但他汀类药物治疗可改善PWCS患者的临床预后。他汀类药物在心源性卒中的治疗中起着有益的作用。
BackgroundSeveral real-world observational studies have investigated the association between statin treatment and outcomes of cardioembolic stroke. However, substantial uncertainties remain about this association.ObjectiveWe aimed to perform a systematic review and meta-analysis to determine the effect of statin treatment on the outcomes of cardioembolic stroke.MethodsWe systematically searched the PubMed and Embase databases for relevant clinical studies. Pooled relative risks (RRs) and 95% confidence intervals (CIs) with a random-effects model were used to assess the outcomes of interest.ResultsA total of 18 observational studies published between 2009 and 2020 were included. No randomized clinical trial was found. Compared with non-statin treatment, statin treatment was not associated with a decreased risk of stroke recurrence in patients with cardioembolic stroke [PWCS] (RR, 0.93; 95% CI 0.82–1.06). However, compared with non-statin treatment, statin treatment was associated with a lower risk of all-cause death (RR, 0.59; 95% CI 0.49–0.73) and better functional outcomes (RR, 0.67; 95% CI 0.47–0.97) in PWCS. There was no significant association between statin treatment and major bleeding event risk in PWCS (RR, 0.35; 95% CI 0.06–2.16). Compared with non-statin treatment, statin treatment was not associated with a decreased risk of coronary atherosclerotic disease in PWCS (RR, 1.04; 95% CI 0.96–1.11).ConclusionsAlthough the use of statins does not enhance the prevention of stroke recurrence in PWCS, statin treatment is associated with improved clinical outcomes in PWCS. Statins play a beneficial role in the treatment of cardioembolic stroke.
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影响因子：
1.6
作者：
Wu YL;Saver JL;Chen PC;Lee JD;Wang HH;Rao NM;Lee M;Ovbiagele B
通讯作者：
Ovbiagele B
影响因子：
5.1
作者：
Martinez-Sanchez, P.;Rivera-Ordonez, C.;Diez-Tejedor, E.
通讯作者：
Diez-Tejedor, E.
影响因子：
8.3
作者：
Myrna M E van Dongen;K. Aarnio;N. Martinez-Majander;J. Pirinen;J. Sinisalo;M. Lehto;M. Kaste;T. Tatlisumak;F. de Leeuw;J. Putaala
通讯作者：
Myrna M E van Dongen;K. Aarnio;N. Martinez-Majander;J. Pirinen;J. Sinisalo;M. Lehto;M. Kaste;T. Tatlisumak;F. de Leeuw;J. Putaala
DOI：
10.1016/j.jstrokecerebrovasdis.2017.11.002
发表时间：
2017-12
期刊：
Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
影响因子：
--
作者：
M. Yasaka;Y. Koretsune;T. Yamashita;E. Oda;D. Matsubayashi;K. Ota;Masafumi Kobayashi;Y. Matsushita;Jumpei Kaburagi;Kei Ibusuki;A. Takita;Mikio Iwashita;Takuhiro Yamaguchi
通讯作者：
M. Yasaka;Y. Koretsune;T. Yamashita;E. Oda;D. Matsubayashi;K. Ota;Masafumi Kobayashi;Y. Matsushita;Jumpei Kaburagi;Kei Ibusuki;A. Takita;Mikio Iwashita;Takuhiro Yamaguchi
DOI：
10.1016/s0734-3299(08)70393-9
发表时间：
2007
期刊：
Yearbook of Critical Care Medicine
影响因子：
--
作者：
J. Provencio
通讯作者：
J. Provencio