Evidence map›Paper›PMID 35459718›Full record

ArticleOpen heart2022

Use of lipid-lowering therapy after ischaemic stroke and expected benefit from intensification of treatment.

Mari Nordbø Gynnild, Steven H J Hageman, Olav Spigset, Stian Lydersen, Ingvild Saltvedt, Jannick A N Dorresteijn, Frank L J Visseren, Hanne Ellekjær

Registry-linked trialOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Open heart, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02650531 (Norwegian COgnitive Impairment After STroke), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.7field-weighted citation impact, top 16% 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.

NCT02650531 completednot on this map

Norwegian COgnitive Impairment After STroke (NorCOAST) Study

TypeobservationalSponsorNorwegian University of Science and TechnologyRan2015 to 2018Enrolled816ConditionsDementia, Mild Cognitive Impairment, Stroke
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 9 citations in OpenAlex.

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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

8 authors at 3 institutions in 2 countries.

Mari Nordbø GynnildDepartment of Neuromedicine and Movement Science, Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Trondheim, Norway mari.nordbo.gynnild@ntnu.no.ORCID 0000-0001-8623-7911
Steven H J HagemanDepartment of Vascular Medicine, University Medical Centre Utrecht, Utrecht, Netherlands.
Olav SpigsetDepartment of Clinical Pharmacology, St Olavs Hospital Trondheim University Hospital, Trondheim, Norway.
Stian LydersenDepartment of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
Ingvild SaltvedtDepartment of Neuromedicine and Movement Science, Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Trondheim, Norway.
Jannick A N DorresteijnDepartment of Vascular Medicine, University Medical Centre Utrecht, Utrecht, Netherlands.
Frank L J VisserenDepartment of Vascular Medicine, University Medical Centre Utrecht, Utrecht, Netherlands.
Hanne EllekjærDepartment of Neuromedicine and Movement Science, Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Science, Trondheim, Norway.
St Olav's University Hospital · NOUniversity Medical Center Utrecht · NLNorwegian University of Science and Technology · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesElevated low-density lipoprotein cholesterol (LDL-C) increases the risk of recurrent cardiovascular disease (CVD) events. We examined use of lipid-lowering therapy (LLT) following ischaemic stroke, and estimated benefits from guideline-based up-titration of LLT.

methodsThe Norwegian COgnitive Impairment After STroke (Nor-COAST) study, a multicentre prospective cohort study, collected data on LLT use, dose intensity and LDL-C levels for 462 home-dwelling patients with ischaemic stroke. We used the Secondary Manifestations of Arterial Disease-Reduction of Atherothrombosis for Continued Health (SMART-REACH) model to estimate the expected benefit of up-titrating LLT.

resultsAt discharge, 92% received LLT (97% statin monotherapy). Patients with prestroke dementia and cardioembolic stroke aetiology were less likely to receive LLT. Older patients (coefficient -3 mg atorvastatin per 10 years, 95% CI -6 to -0.5) and women (coefficient -5.1 mg atorvastatin, 95% CI -9.2 to -0.9) received lower doses, while individuals with higher baseline LDL-C, ischaemic heart disease and large artery stroke aetiology received higher dose intensity. At 3 months, 45% reached LDL-C ≤1.8 mmol/L, and we estimated that 81% could potentially reach the target with statin and ezetimibe, resulting in median 5 (IQR 0-12) months of CVD-free life gain and median 2% 10-year absolute risk reduction (IQR 0-4) with large interindividual variation.

conclusionPotential for optimisation of conventional LLT use exists in patients with ischaemic stroke. Awareness of groups at risk of undertreatment and objective estimates of the individual patient's benefit of intensification can help personalise treatment decisions and reduce residual cholesterol risk. TRIAL REGISTRATION NUMBER: NCT02650531.

Indexed as

Hydroxymethylglutaryl-CoA Reductase InhibitorsIschemic StrokeAgedAtorvastatinCholesterol, LDLFemaleHumansMaleMulticenter Studies as TopicProspective StudiesAtorvastatinCholesterol, LDLHydroxymethylglutaryl-CoA Reductase Inhibitorshyperlipidemiasmedication adherencepharmacology, clinicalstroke

Identifiers

PMID35459718
PMCPMC9036470
OpenAlexW4224315903

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

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.