SynthesisJournal of the American Heart Association2024
Lipid-Lowering Therapy and Risk of Hemorrhagic Stroke: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Synthesis in Journal of the American Heart Association, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
20 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Advances in statin adverse reactions and the potential mechanisms: A systematic review.Journal of advanced research · 2025Pooled it
- Glucagon-Like Peptide-1 Receptor Agonists and Risk of Venous Thromboembolism: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Journal of the American Heart Association · 2025Pooled it
- High-dose statins for the prevention of recurrent ischemic stroke: a systematic review and meta-analysis of randomized controlled trials.Annals of Saudi medicinePooled it
- Article
- Lipid Management for Secondary Prevention in Atherosclerotic Cardiovascular Disease: A Scoping Review and Scientific Report.Journal of atherosclerosis and thrombosis · 2026Article
- Primary and Secondary Prevention of Ischemic Stroke in Elderly Patients with Cardiovascular Disease: The Role of Frailty and Care Pathways.Neurology international · 2026Review
- 2025 Egyptian guidelines for the management of dyslipidemia.The Egyptian heart journal : (EHJ) : official bulletin of the Egyptian Society of Cardiology · 2026Review
- Safety Profile of Statins: An Umbrella Review of Systematic Reviews and Meta-analyses.European cardiology · 2026Review
- Pushing the limits of LDL cholesterol: Emerging paradigms in cardiovascular risk reduction.Trends in cardiovascular medicine · 2025Review
- Association between lipid profiles and early clinical outcomes in acute ischemic stroke: a single-center cohort study in the Chinese population.BMC neurology · 2025Article
- The role of 25-hydroxycholesterol in the pathophysiology of brain vessel dysfunction associated with infection and cholesterol dysregulation.Disease models & mechanisms · 2025Article
- Low LDL-Cholesterol and Hemorrhagic Risk: Mechanistic Insights and Clinical Perspectives.International journal of molecular sciences · 2025Review
- Reducing LDL-Cholesterol to Very Low Levels: Sailing Between Established Benefits and Potential Risks.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2025Review
- Association of LDL-C with stroke and all-cause mortality in hypertensive patients with high risk of ASCVD.Clinical hypertension · 2025Article
- The association between basal metabolic rate and ischemic stroke: a Mendelian randomization study.Frontiers in neurology · 2025Article
- Breaking down the Dyslipidemia-Stroke Relationship in Southeast Asian American Subgroups: Advancing Toward Cardiovascular Health Equity.Current epidemiology reports · 2025Review
- Article
- Low LDL-C: Is It all Good News?Current atherosclerosis reports · 2024Review
- Lipid-Lowering Therapy and Hemorrhagic Stroke: A Never-Ending Debate of Clinical Implications. Have We Found the Answer?Journal of the American Heart Association · 2024Article
- The plasma lipids with different fatty acid chains are associated with the risk of hemorrhagic stroke: a Mendelian randomization study.Frontiers in neurology · 2024Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is debate over whether statins increase risk of hemorrhagic stroke, so we assessed current evidence, including data from new statin trials and trials of nonstatin low-density lipoprotein-cholesterol (LDL-C)- and triglyceride-lowering therapies. METHODS AND
resultsWe performed a systematic review of large randomized clinical trials (≥1000 patients with ≥2 years follow-up) of LDL-C-lowering therapy (statin, ezetimibe, and PCSK-9 [proprotein convertase subtilisin/kexin type 9] inhibitor) and triglyceride-lowering therapy (omega-3 supplements and fibrate) that reported hemorrhagic stroke as an outcome. We searched MEDLINE, Embase, and Cochrane Library up to July 2, 2021 and updated a meta-analysis of cardiovascular statin trials published in 2012. Among our several subgroup analyses, we looked at difference depending on stroke status and also depending on age. We identified 37 trials for LDL-C lowering (284 301 participants) and 11 for triglyceride lowering (120 984 participants). Overall, we found a higher risk of hemorrhagic stroke for LDL-C lowering, risk ratio (RR) 1.16 (95% CI, 1.01-1.32,
conclusionsWe found evidence for a small increased risk of hemorrhagic stroke events with LDL-C-lowering therapies but no clear evidence for triglyceride-lowering therapies. REGISTRATION: URL: https://www.crd.york.ac.uk/prospero; Unique identifier: CRD42021275363.
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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.