Evidence mapPaperPMID 28302952Full record

Trial reportJournal of atherosclerosis and thrombosis2017

Reduction in High-Sensitivity C-Reactive Protein Levels in Patients with Ischemic Stroke by Statin Treatment: Hs-CRP Sub-Study in J-STARS.

Kazuo Kitagawa, Naohisa Hosomi, Yoji Nagai, Tatsuo Kagimura, Toshiho Ohtsuki, Hideki Origasa, Kazuo Minematsu, Shinichiro Uchiyama, Masakazu Nakamura, Masayasu Matsumoto and 1 more

Open access · diamondAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Journal of atherosclerosis and thrombosis, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 5 pooled it
6.2field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 5 syntheses or guidelines pooled it, 53 citations in OpenAlex.

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  15. Statins-From Fungi to Pharmacy.International journal of molecular sciences · 2023
    Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 8 institutions in 2 countries.

Kazuo KitagawaDepartment of Neurology, Tokyo Women's Medical University.
Naohisa HosomiDepartment of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences.
Yoji NagaiCenter for Clinical Research, Kobe University Hospital.
Tatsuo KagimuraFoundation for Biomedical Research and Innovation, Translational Research Informatics Center.
Toshiho OhtsukiStroke Center, Kindai University Hospital.
Hideki OrigasaDivision of Biostatistics and Clinical Epidemiology, University of Toyama Graduate School of Medicine and Pharmaceutical Sciences.
Kazuo MinematsuNational Cerebral and Cardiovascular Center.
Shinichiro UchiyamaClinical Research Center, International University of Health and Welfare, Center for Brain and Cerebral Vessels, Sanno Hospital and Sanno Medical Center.
Masakazu NakamuraNational Cerebral and Cardiovascular Center.
Masayasu MatsumotoDepartment of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences.
J-STARS Investigators
Hiroshima University · JPNational Cerebral and Cardiovascular Center · JPCenter for Clinical Research (United States) · USFoundation for Biomedical Research · USInternational University of Health and Welfare · JPKindai University Hospital · JPTokyo Women's Medical University · JPUniversity of Toyama · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsThe pleiotropic effects of statins on recurrent stroke remain unclear. We investigated the effects of pravastatin on high-sensitivity C-reactive proteins (Hs-CRP) in ischemic stroke, and explored the impact of Hs-CRP on recurrent stroke and vascular events.

methodsThis randomized open-label trial was ancillary to the J-STARS trial. One thousand and ninety-five patients with non-cardiogenic ischemic stroke were assigned to the pravastatin (n=545) or control groups (n=550). The primary and secondary endpoints were serum Hs-CRP reduction and stroke recurrence, including both ischemic and hemorrhagic ones, respectively. Onset of vascular events and each stroke subtype in relation to Hs-CRP levels were also determined.

resultsIn the pravastatin treatment group, Hs-CRP levels (median 711 µg/L, IQR 344-1500) significantly decreased 2 months later (median 592 µg/L, IQR 301-1390), and they remained significantly lower until the end of the study. However, in the control group, baseline Hs-CRP levels were similar to those 2 months later. The reduction of Hs-CRP levels from the baseline to 2 months in the pravastatin group was statistically significant compared with the control (p=0.007). One SD increase in log-transformed Hs-CRP increased the risk of stroke recurrence (HR 1.17, 95% CI 0.97-1.40) and vascular events (HR 1.30, 95% CI 1.12-1.51). With an Hs-CRP cut-off of 1000 µg/L, higher Hs-CRP significantly increased the risk of recurrent stroke (HR 1.50, 95% CI 1.03-2.17)and vascular events (HR 1.68, 95% CI 1.23-2.29).

conclusionIn non-cardiogenic ischemic stroke, pravastatin treatment may reduce vascular inflammation as assessed by Hs-CRP, and higher Hs-CRP levels appeared to increase the risk of recurrent stroke and vascular events.

Indexed as

AgedAged, 80 and overBrain IschemiaC-Reactive ProteinFemaleFollow-Up StudiesHumansHydroxymethylglutaryl-CoA Reductase InhibitorsIncidenceInflammationMaleMiddle AgedPravastatinRecurrenceRiskStrokeC-Reactive ProteinHydroxymethylglutaryl-CoA Reductase InhibitorsPravastatinC-reactive proteinInflammationIschemic strokeStatin

Identifiers

PMID28302952
PMCPMC5656766
OpenAlexW2592082417

What Socratic holds

Textmetadata
LicenceCC BY-NC-SA
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.