Pravastatin Reduces the Risk of Atherothrombotic Stroke when Administered within Six Months of an Initial Stroke Event

Aims: The J-STARS study examined whether pravastatin (10 mg/day) reduces recurrence of stroke in non-cardioembolic ischemic stroke patients who were enrolled within 1 month to 3 years after initial stroke events (ClinicalTrials.gov, NCT00221104). The main results showed that the frequency of atherot...

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Published in:Journal of Atherosclerosis and Thrombosis 2018/03/01, Vol.25(3), pp.262-268
Main Authors: Hosomi, Naohisa, Nagai, Yoji, Kitagawa, Kazuo, Nakagawa, Yoko, Aoki, Shiro, Nezu, Tomohisa, Kagimura, Tatsuo, Maruyama, Hirofumi, Origasa, Hideki, Minematsu, Kazuo, Uchiyama, Shinichiro, Matsumoto, Masayasu, collaborators, J-STARS
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Atherothrombotic
Cholesterol
Cohort Studies
Drug Administration Schedule
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Incidence
Japan
Male
Middle Aged
Original
Pravastatin - therapeutic use
Prevention
Proportional Hazards Models
Recurrence
Risk
Statin
Stroke
Stroke - drug therapy
Stroke - prevention & control
Thrombosis - prevention & control
Time Factors
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Summary:Aims: The J-STARS study examined whether pravastatin (10 mg/day) reduces recurrence of stroke in non-cardioembolic ischemic stroke patients who were enrolled within 1 month to 3 years after initial stroke events (ClinicalTrials.gov, NCT00221104). The main results showed that the frequency of atherothrombotic stroke was low in pravastatin-treated patients, although no effect of pravastatin was found for the other stroke subtypes. We evaluated differences of early (within 6 months) or late (after 6 months) pravastatin treatment benefits on the incidence of stroke or transient ischemic attack (TIA), as well as atherothrombotic stroke and the other subtypes.Methods: Subjects in the J-STARS study were classified into two cohorts, depending on whether they enrolled early (1 to 6 months) or late (6 months to 3 years) following initial stroke events.Results: A total of 1578 patients (491 female, 66.2±8.5 years) were randomly assigned to either the pravastatin group (n=793; n=426 in the early cohort, n=367 in the late cohort) or the control group (n=785; n=417 in the early cohort, n=368 in the late cohort). During the follow-up of 4.9± 1.4 years, the rate of atherothrombotic stroke was lower in the pravastatin group compared to controls in the early cohort (0.24 vs. 0.88%/year, p=0.01) but not in the late cohort (0.17 vs. 0.39%/year, p=0.29). However, this difference of pravastatin effect on atherothrombotic stroke was not significantly interacted by the early or late cohort (p=0.59). The incidence rates of other stroke subtype were not different in between pravastatin and control groups despite the timing of entry.Conclusions: Pravastatin is likely to reduce atherothrombotic stroke in patients enrolled within 6 months after stroke onset. However, the clinical efficacy for prevention of recurrent stroke was not conclusive with earlier statin treatment.
ISSN:1340-3478
1880-3873
DOI:10.5551/jat.40196