当前位置: X-MOL 学术N. Engl. J. Med. › 论文详情
A Comparison of Two LDL Cholesterol Targets after Ischemic Stroke.
The New England Journal of Medicine ( IF 74.699 ) Pub Date : 2019-11-18 , DOI: 10.1056/nejmoa1910355
Pierre Amarenco,Jong S Kim,Julien Labreuche,Hugo Charles,Jérémie Abtan,Yannick Béjot,Lucie Cabrejo,Jae-Kwan Cha,Grégory Ducrocq,Maurice Giroud,Celine Guidoux,Cristina Hobeanu,Yong-Jae Kim,Bertrand Lapergue,Philippa C Lavallée,Byung-Chul Lee,Kyung-Bok Lee,Didier Leys,Marie-Hélène Mahagne,Elena Meseguer,Norbert Nighoghossian,Fernando Pico,Yves Samson,Igor Sibon,P Gabriel Steg,Sang-Min Sung,Pierre-Jean Touboul,Emmanuel Touzé,Olivier Varenne,Éric Vicaut,Nessima Yelles,Eric Bruckert,

BACKGROUND The use of intensive lipid-lowering therapy by means of statin medications is recommended after transient ischemic attack (TIA) and ischemic stroke of atherosclerotic origin. The target level for low-density lipoprotein (LDL) cholesterol to reduce cardiovascular events after stroke has not been well studied. METHODS In this parallel-group trial conducted in France and South Korea, we randomly assigned patients with ischemic stroke in the previous 3 months or a TIA within the previous 15 days to a target LDL cholesterol level of less than 70 mg per deciliter (1.8 mmol per liter) (lower-target group) or to a target range of 90 mg to 110 mg per deciliter (2.3 to 2.8 mmol per liter) (higher-target group). All the patients had evidence of cerebrovascular or coronary-artery atherosclerosis and received a statin, ezetimibe, or both. The composite primary end point of major cardiovascular events included ischemic stroke, myocardial infarction, new symptoms leading to urgent coronary or carotid revascularization, or death from cardiovascular causes. RESULTS A total of 2860 patients were enrolled and followed for a median of 3.5 years; 1430 were assigned to each LDL cholesterol target group. The mean LDL cholesterol level at baseline was 135 mg per deciliter (3.5 mmol per liter), and the mean achieved LDL cholesterol level was 65 mg per deciliter (1.7 mmol per liter) in the lower-target group and 96 mg per deciliter (2.5 mmol per liter) in the higher-target group. The trial was stopped for administrative reasons after 277 of an anticipated 385 end-point events had occurred. The composite primary end point occurred in 121 patients (8.5%) in the lower-target group and in 156 (10.9%) in the higher-target group (adjusted hazard ratio, 0.78; 95% confidence interval, 0.61 to 0.98; P = 0.04). The incidence of intracranial hemorrhage and newly diagnosed diabetes did not differ significantly between the two groups. CONCLUSIONS After an ischemic stroke or TIA with evidence of atherosclerosis, patients who had a target LDL cholesterol level of less than 70 mg per deciliter had a lower risk of subsequent cardiovascular events than those who had a target range of 90 mg to 110 mg per deciliter. (Funded by the French Ministry of Health and others; Treat Stroke to Target ClinicalTrials.gov number, NCT01252875.).
更新日期:2020-01-02

 

全部期刊列表>>
材料学研究精选
Springer Nature Live 产业与创新线上学术论坛
胸腔和胸部成像专题
自然科研论文编辑服务
ACS ES&T Engineering
ACS ES&T Water
屿渡论文,编辑服务
杨超勇
周一歌
华东师范大学
南京工业大学
清华大学
中科大
唐勇
跟Nature、Science文章学绘图
隐藏1h前已浏览文章
中洪博元
课题组网站
新版X-MOL期刊搜索和高级搜索功能介绍
ACS材料视界
x-mol收录
福州大学
南京大学
王杰
左智伟
湖南大学
清华大学
吴杰
赵延川
中山大学化学工程与技术学院
试剂库存
天合科研
down
wechat
bug