Effect of In-Hospital Initiation of Lipid-Lowering Therapy on Six-Month Outcomes in Patients With Acute Ischemic Stroke or Transient Ischemic Attack

Poh Shiow Yeh, Huey Juan Lin, Chyi Huey Bai, Fang I. Hsieh, Der Shin Ke, Yi-Heng Li

Research output: Contribution to journalArticle

11 Citations (Scopus)

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 ≥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.

Original languageEnglish
Pages (from-to)1490-1494
Number of pages5
JournalAmerican Journal of Cardiology
Volume105
Issue number10
DOIs
Publication statusPublished - 2010 May 15

Fingerprint

Transient Ischemic Attack
Stroke
Lipids
Therapeutics
Group Psychotherapy
Selection Bias
Acute Coronary Syndrome
Taiwan
Myocardial Ischemia
Prescriptions
Registries
Cause of Death
Regression Analysis
Confidence Intervals

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Yeh, Poh Shiow ; Lin, Huey Juan ; Bai, Chyi Huey ; Hsieh, Fang I. ; Ke, Der Shin ; Li, Yi-Heng. / Effect of In-Hospital Initiation of Lipid-Lowering Therapy on Six-Month Outcomes in Patients With Acute Ischemic Stroke or Transient Ischemic Attack. In: American Journal of Cardiology. 2010 ; Vol. 105, No. 10. pp. 1490-1494.
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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 ≥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.",
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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. / Yeh, Poh Shiow; Lin, Huey Juan; Bai, Chyi Huey; Hsieh, Fang I.; Ke, Der Shin; Li, Yi-Heng.

In: American Journal of Cardiology, Vol. 105, No. 10, 15.05.2010, p. 1490-1494.

Research output: Contribution to journalArticle

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