scholarly journals Gene Polymorphisms Affect the Effectiveness of Atorvastatin in Treating Ischemic Stroke Patients

2016 ◽  
Vol 39 (2) ◽  
pp. 630-638 ◽  
Author(s):  
Yun-Hua Yue ◽  
Xu-dong Bai ◽  
Hui-jun Zhang ◽  
You-mei Li ◽  
Liang Hu ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Lipid Level ◽  
Blood Lipid ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Stroke Patients ◽  
Single Nucleotide ◽  
Atorvastatin Calcium ◽  
Lpl Gene ◽  
Apoa5 Gene

Background/Aims: The aim of the present study is to investigate whether the single nucleotide polymorphism (SNP) in lipid metabolism related genes would affect the effectiveness of atorvastatin in both Han and Uighur populations. Methods: 200 ischemic stroke patients were treated with atorvastatin. The differences of blood lipid level and their ratios were measured. Six lipid related genes, HMGCR, APOA5, LPL, CETP, LDLR and PCSK9 were selected as candidate genes. And nine SNP loci in these six genes were genotyped by SNaPshot technique. Results: In all patients treated with atorvastatin, the SNP rs662799 significantly affected the ratio of ΔLDL and ΔLDL/LDL (p < 0.05); the SNP rs320 significantly affected the ratio of ΔLDL/LDL and Δ(LDL/HDL)/(LDL/HDL) (p < 0.01) and the SNP rs708272 significantly affected the ratio of ΔLDL (p < 0.05). In Han population treated with atorvastatin, the SNP rs662799 significantly affected the ratio of ΔTG (p < 0.05); the SNP rs320 significantly affected the ratio of ΔLDL/LDL and Δ(LDL/HDL)/(LDL/HDL) (p < 0.01). In Uighur population treated with atorvastatin, the SNP rs2266788 significantly affected the ratio of ΔHDL (p < 0.05); the SNP rs662799 significantly affected the ratio of ΔLDL/LDL (p < 0.05) and the SNP rs708272 significantly affected the ratio of ΔLDL (p < 0.05). Conclusion: Polymorphisms of rs662799 and rs2266788 in APOA5 gene, rs320 in LPL gene and rs708272 in CETP gene had significant association with the effect of the lipid-lowering therapy via atorvastatin calcium on ischemic stroke patients.

scholarly journals Meta-Analysis of Dyslipidemia Management for the Prevention of Ischemic Stroke Recurrence in China

2020 ◽  
Vol 11 ◽  
Author(s):  
Kang-Ning Chen ◽  
Li He ◽  
Lian-Mei Zhong ◽  
Yu-Qin Ran ◽  
Yan Liu
Keyword(s):  
Ischemic Stroke ◽  
Recurrent Stroke ◽  
Meta Analysis ◽  
Blood Lipid ◽  
Lipid Lowering ◽  
Stroke Recurrence ◽  
Lipid Lowering Therapy ◽  
Stroke Patients ◽  
Control Groups ◽  
Lowering Therapy

Background: The benefit of blood cholesterol reduction for secondary prevention of ischemic stroke remains undetermined in Chinese patients. The purpose of this meta-analysis was to determine whether lipid-lowering agents including statins, fibrates, nicotinic acid, and ezetimibe reduced the risk of recurrent stroke in ischemic stroke patients in China and whether such findings could inform treatment decisions for blood lipid-lowering treatment in China.Methods: The English electronic databases PubMed, EMBASE, Cochrane Library and Chinese databases CNKI, Sino-Med, Wan Fang, and VIP were searched for studies published between January 1990 and April 2020. This meta-analysis included published data from trials that randomly assigned patients to groups treated with either blood lipid-lowering regimens or placebo. Effect comparisons were made using fixed effects model in meta-analysis and linear and spline regression were performed to identify the relative risk of stroke recurrence. The primary outcome was the reduction of total ischemic stroke events, and relative risk values were obtained using a risk prediction equation developed from the control groups of the included trials.Results: Five studies including 4,999 individuals with available data met the inclusion criteria. Relative to the control groups, the pooled estimated odds ratio (OR) for recurrent stroke among those who received lipid-lowering therapy was 0.79 (95% confidence interval [CI]: 0.63–1.00). A 50% or greater reduction in low-density lipoprotein cholesterol (LDL-C) significantly reduced the risk of ischemic stroke recurrence (OR: 0.15 [95% CI: 0.11–0.20]). The overall beneficial effect of statin therapy was confirmed to prevent ischemic stroke with an OR of 0.51 (95% CI: 0.36–0.72).Conclusions: Effective lipid-lowering therapy could decrease the blood LDL-C level, which had a protective effect against stroke recurrence. These results support the use of predicted baseline cerebrovascular disease risk equations to inform decisions regarding blood lipid-lowering treatment in ischemic stroke patients in China.

Abstract P560: Delipid Extracorporeal Lipoprotein Filter System: A New Lipid-Lowering Therapy for Acute Ischemic Stroke Patients

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Yuqiong Jiao ◽  
Ting Ye ◽  
Xiang Han
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Plasma Lipids ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Adsorption System ◽  
Stroke Patients ◽  
Safety Parameters

Objectives: The purpose of this study was to illustrate a new low-density lipoprotein cholesterol (LDL-C) adsorption system, Delipid Extracorporeal Lipoprotein filter from Plasma (DELP) system, and evaluate its safety and efficacy in acute ischemic stroke patients. Methods: This is an observational study of 22 acute ischemic stroke patients who underwent DELP treatment from March to August 2019. The DELP system was composed of a plasma filter JX-DELP, a COM.TEC cell separator and Tubing P1R Plasma Treatment Set. Clinical data and laboratory results including plasma lipids and some safety parameters before and after the apheresis were collected and analyzed. Results: The present study included 22 patients (15 males, 7 females, 59.95±13.71 years). The mean LDL-C was significantly reduced from 3.36±0.64 mmol/L to 2.30±0.53 mmol/L (31.5%, p <0.001, n=22) during a single DELP treatment, and from 3.59±0.48 mmol/L to 1.85±0.50 mmol/L (48.2%, p <0.001, n=13) after two apheresis, respectively. No clinically relevant changes were observed in hematologic safety parameters during DELP treatments. Conclusions: We concluded that the new LDL-C adsorption system is a promising method for timely and controllable LDL-C administration in acute ischemic stroke patients in view of its high efficacy, simple operation, and safety.

Abstract WP320: The Management of low Density Lipid Cholesterol and Predictors of Goal Achievement in Stroke Patients in China

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Chunjuan Wang ◽  
Yilong Wang ◽  
Zixiao Li ◽  
Yongjun Wang
Keyword(s):  
Ischemic Stroke ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Goal Achievement ◽  
Lipoprotein Cholesterol ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Low Density ◽  
Low Density Lipoprotein Cholesterol ◽  
Stroke Patients

Background and Purpose: Modification of low-density lipoprotein cholesterol (LDL-C) has been proved to be an essential component in the primary and secondary prevention of stroke. However, limited data are available on LDL-C goal achievement in patients with ischemic stroke in China. The aim of this study was to assess the management of low-density lipoprotein cholesterol (LDL-C) in patients suffering from ischemic stroke within 6-12 months and to explore the predictors of the achievement of LDL-C target. Method: This study was a nation-wide, multicenter, cross-sectional study conducted from July 2013 to August 2013. Patients who had an ischemic stroke within 6-12 months and were more than 18-year old were included into this study. All data referred to personal information, medical history, medication and laboratory tests were collected by face-to-face questionnaires, physical examination and blood tests. The predictors for the achievement of LDL-C target (<1.8mmol/l or <70mg/dl) were analyzed by the multivariate analysis. Results: In this study, a total of 3956 cases from 56 centers suffered from ischemic stroke within 6-12 months were finally included into this study. The average serum level of LDL-C in all these patients was 2.42 ± 0.91mmol/l with the median of 2.30 mmol/l and the total LDL-C goal achievement rate is 27.35% (95% CI: 25.97%-28.77%). Lipid-lowering therapy (Odds Ratio [OR]=3.045, 95%CI: 2.456-3.810) was the most significant predictor for LDL-C target achievement and female (OR=0.684, 95% CI: 0.540-0.867), current smoking (OR=0.627, 95% CI: 0.480-0.817), and history of dyslipidemia (OR=0.592, 95% CI: 0.497-0.704) were three other important factors for the LDL-C goal achievement. Conclusions: Although the lipid modulation in stroke patients is recommended by the international guidelines, the goal achievement of LDL-C was still very low in this population in China. The modifiable predictors including the use of lipid-lowering drugs and smoking cessation should be improved in dyslipidemia management.

Evaluation on the compliance with secondary prevention and influence factors of ischemic stroke in Hainan province, China

Vascular ◽  
2013 ◽  
Vol 22 (3) ◽  
pp. 181-187 ◽  
Author(s):  
Qingjie Su ◽  
Kunxiong Yuan ◽  
Faqing Long ◽  
Zhongqin Wan ◽  
Chaoyun Li ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Health Education ◽  
Secondary Prevention ◽  
Antiplatelet Therapy ◽  
Influence Factors ◽  
Significant Risk ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Logistic Regression Models ◽  
Prevention Therapy

Survivors of ischemic stroke are still at a significant risk for recurrence. Numerous effective strategies for the secondary prevention of ischemic stroke have now been established; however, these guidelines are not widely known. In this retrospective, a multicenter study was conducted from January 2011 to February 2012 in 10 general hospitals, which included 1300 elderly patients who had previously been diagnosed with ischemic stroke and re-admitted to hospitals. Logistic regression models were fitted to determine the relationship between compliance with secondary prevention therapy and each variable of interest. The treatment rates of antihypertensive, antiplatelet and lipid-lowering therapy were only 56.3%, 48.9% and 19.6%, respectively. Multivariate analysis presented that cardiovascular risk factors would motivate patients with hypertension and hyperlipidemia to receive corresponding treatments. However, it is worth noting that they did not influence the use of antiplatelet therapy. In addition, high education, health education and insurance promote the use of secondary prevention in patients. In conclusion, the importance of antiplatelet therapy should not be ignored any more. Besides, health education will raise patients’ attention to ischemic stroke.

scholarly journals Statins in patients with acute ischemic stroke: when we should start therapy?

2021 ◽  
Vol 27 (1) ◽  
pp. 16-28
Author(s):  
S. N. Yanishevskiy ◽  
I. B. Skiba ◽  
A. Y. Polushin
Keyword(s):  
Ischemic Stroke ◽  
Clinical Practice ◽  
Acute Onset ◽  
Lipid Lowering ◽  
Original Position ◽  
Optimal Time ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy ◽  
Different Populations ◽  
Exact Timing

Lipid-lowering therapy is known to be an important part of ischemic stroke secondary prevention, however, the exact timing of its initiation or re-starting in the patients with ischemic stroke is not yet defined strictly. Accumulating evidence of pleiotropic (i. e. non-lipid-lowering) effects of statins in various conditions, including ischemia, urges their implementation in the clinical practice. In this review, we discuss the evidence on the effectiveness of early statin introduction in different populations of patients with ischemic stroke. We also attempt to define our original position on the optimal time after the acute onset of neurological symptoms to introduce lipid-lowering therapy.

Antiplatelet Treatment with Aggressive Lipid Lowering Therapy and Reduction of Clinical Event after Ischemic Stroke.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4141-4141
Author(s):  
Giorgio Corinaldesi ◽  
Christian Corinaldesi
Keyword(s):  
Ischemic Stroke ◽  
Combined Treatment ◽  
Clinical Problem ◽  
Lipid Lowering ◽  
Clinical Event ◽  
Lipid Lowering Therapy ◽  
Protective Effects ◽  
Total Period ◽  
Once Daily ◽  
D Dimer

Abstract The objective of the present study is to investigate the effects of anticoagulation and inhibition of platelet aggregation, which is strongly related with ischemic stroke, with aspirin 100 mg/once daily and clopidogrel 75 mg/once daily together with atorvastatin 80 mg/once daily then evaluating the event free survival in patients who had stroke with LDL-C &gt; 130 mg/dl. An hypolipidaemic diet was given to every patient. As known statins other than reducing LDL-C (silent killer), has many other effects characterized by a wider and wider checklist: reduction of plasmatic levels of C-reactive protein, of MCP-1, and the monocyte traffic, of IL-6, TNF-alfa, of S-VCAM-1, of COX-2 and MMP-9, and upregulate the TPA, and downregulate the PAI-1, statins also reduce the expression of CD40 on the endothelial surface, thus augmenting the EPC (endothelial progenitor cells) involved in neo-vascularization of ischemic tissue, with a final protective effects over the vascular endothelium, including the plaque stabilization. We have studied 67 patients with a previous ischemic stroke aged between 58 and 72 years (25% smoker, 32% with hypertension, 14% with diabetes, 6% with obesity), with LDL-C higher than 130 mg/dl, evaluating in particular the lipidic profile (total cholesterol, HDL, LDL, TG, Lpa), fibrinogen and d-dimer for a total period of 36 months. We observed a clear reduction of lipidic parameters: Total-C &lt;42%, LDL-C &lt;46%, TG &lt;30%, ApoB &lt;35%, d-dimer &lt;10%, and we did not observe any increase in transaminases, CPK, or fibrinogen. We observed 12 patients with relapsing clinical events requiring emergency hospitalization: 1 exitus for second stroke two months after the first event, 11 cases of RIND, with less than 4 transitory ischemic episodes, with the total length of events significantly reduced after the first 18 weeks of treatment. We have observed 22 adverse effects events: 4 cases of epistaxis, 2 case of tooth bleeding, 3 of abdominal pain, 9 of muscular pain, 2 of chest pain, 2 case of headache, however, these events did not influence the course of the pharmacological treatment; 55 patients did not refer any clinical problem, every patient has been followed on the basis of a three months period, and on demand. The present study has demonstrated a secure efficacy of the aggressive combined treatment (antiplatelet + statin) in the management of patients with a previous stroke, showing a symptomatologic benefit (reduction of the total ischemic events and of the emergencies) with an overall improvement of the quality of life. PARAMETER BEFORE AFTER TOTAL-C 320.0 mg/dl 180.0 mg/dl LDL-C 148.0 mg/dl 82.4 mg/dl HDL-C 38.6 mg/dl 44.2 mg/dl TG 180.0 mg/dl 108.2 mg/dl FIBRINOGEN 460.0 mg/dl 370.0 mg/dl FASTING GLUCOSE 110.0 mg/dl 96.0 mg/dl

scholarly journals Fasting lipid profile in acute ischemic stroke patients who are already on lipid-lowering drugs: An observational study

2020 ◽  
Vol 19 (4) ◽  
pp. 286-291
Author(s):  
Muhammad Sohaib Asghar ◽  
◽  
Muhammad Nadeem Ahsan ◽  
Zara Saeed ◽  
Faran Khalid ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Observational Study ◽  
Acute Ischemic Stroke ◽  
Lipid Profile ◽  
Lipid Lowering ◽  
Stroke Patients ◽  
Lipid Lowering Drugs
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