Role of Blood Lipid Levels and Lipid-Lowering Therapy in Stroke Patients with Different Levels of Cerebral Artery Diseases: Reconsidering Recent Stroke Guidelines
Hyperlipidemia is an important risk factor for ischemic stroke; the Stroke Prevention by Aggressive Reduction in Cholesterol Level and Treat Stroke to Target studies have shown that statins are beneficial for patients with stroke and that a low target for low-density lipoprotein cholesterol (LDL-C)...
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| Format: | Article |
| Language: | English |
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Korean Stroke Society
2021-05-01
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| Series: | Journal of Stroke |
| Subjects: | |
| Online Access: | http://www.j-stroke.org/upload/pdf/jos-2021-01249.pdf |
| _version_ | 1818742059082711040 |
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| author | Jong S. Kim |
| author_facet | Jong S. Kim |
| author_sort | Jong S. Kim |
| collection | DOAJ |
| description | Hyperlipidemia is an important risk factor for ischemic stroke; the Stroke Prevention by Aggressive Reduction in Cholesterol Level and Treat Stroke to Target studies have shown that statins are beneficial for patients with stroke and that a low target for low-density lipoprotein cholesterol (LDL-C) concentration may maximize this benefit. Based on these results, recent guidelines have emphasized the application of “high-intensity statins” and “low LDL-C target” strategies in patients with stroke. However, it should be kept in mind that the role of blood lipids as a risk factor and benefit of lipid-lowering therapy are different among patients with different levels of cerebral arterial diseases. Studies have suggested that hypolipidemia, but not hyperlipidemia, is a risk factor for small vessel diseases (SVDs) such as intracerebral hemorrhages, microbleeds, white matter hyperintensities, and perhaps, lacunar infarction. Although lipid-lowering agents might benefit certain patients with SVD, high-intensity statin and low LDL-C target strategies cannot be applied. In contrast, these strategies are important in patients with extracranial atherosclerosis, such as internal carotid disease, considering ample evidence of the benefits of lipid-lowering agents. Imaging studies have shown that statins stabilize vulnerable plaques in these patients. Although lipid-lowering agents are likely to benefit patients with intracranial atherosclerosis, the degree of their benefit and appropriate target LDL-C level for these patients remain unclear. More studies are needed to elucidate the appropriate lipid-modifying strategies in patients with stroke with different levels of cerebral artery disease. |
| first_indexed | 2024-12-18T02:06:29Z |
| format | Article |
| id | doaj.art-13c606dff4d44866b1c5a372ea8b0a54 |
| institution | Directory Open Access Journal |
| issn | 2287-6391 2287-6405 |
| language | English |
| last_indexed | 2024-12-18T02:06:29Z |
| publishDate | 2021-05-01 |
| publisher | Korean Stroke Society |
| record_format | Article |
| series | Journal of Stroke |
| spelling | doaj.art-13c606dff4d44866b1c5a372ea8b0a542022-12-21T21:24:35ZengKorean Stroke SocietyJournal of Stroke2287-63912287-64052021-05-0123214916110.5853/jos.2021.01249371Role of Blood Lipid Levels and Lipid-Lowering Therapy in Stroke Patients with Different Levels of Cerebral Artery Diseases: Reconsidering Recent Stroke GuidelinesJong S. Kim0 Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, KoreaHyperlipidemia is an important risk factor for ischemic stroke; the Stroke Prevention by Aggressive Reduction in Cholesterol Level and Treat Stroke to Target studies have shown that statins are beneficial for patients with stroke and that a low target for low-density lipoprotein cholesterol (LDL-C) concentration may maximize this benefit. Based on these results, recent guidelines have emphasized the application of “high-intensity statins” and “low LDL-C target” strategies in patients with stroke. However, it should be kept in mind that the role of blood lipids as a risk factor and benefit of lipid-lowering therapy are different among patients with different levels of cerebral arterial diseases. Studies have suggested that hypolipidemia, but not hyperlipidemia, is a risk factor for small vessel diseases (SVDs) such as intracerebral hemorrhages, microbleeds, white matter hyperintensities, and perhaps, lacunar infarction. Although lipid-lowering agents might benefit certain patients with SVD, high-intensity statin and low LDL-C target strategies cannot be applied. In contrast, these strategies are important in patients with extracranial atherosclerosis, such as internal carotid disease, considering ample evidence of the benefits of lipid-lowering agents. Imaging studies have shown that statins stabilize vulnerable plaques in these patients. Although lipid-lowering agents are likely to benefit patients with intracranial atherosclerosis, the degree of their benefit and appropriate target LDL-C level for these patients remain unclear. More studies are needed to elucidate the appropriate lipid-modifying strategies in patients with stroke with different levels of cerebral artery disease.http://www.j-stroke.org/upload/pdf/jos-2021-01249.pdflipidshydroxymethylglutaryl-coa reductase inhibitorsstroke |
| spellingShingle | Jong S. Kim Role of Blood Lipid Levels and Lipid-Lowering Therapy in Stroke Patients with Different Levels of Cerebral Artery Diseases: Reconsidering Recent Stroke Guidelines Journal of Stroke lipids hydroxymethylglutaryl-coa reductase inhibitors stroke |
| title | Role of Blood Lipid Levels and Lipid-Lowering Therapy in Stroke Patients with Different Levels of Cerebral Artery Diseases: Reconsidering Recent Stroke Guidelines |
| title_full | Role of Blood Lipid Levels and Lipid-Lowering Therapy in Stroke Patients with Different Levels of Cerebral Artery Diseases: Reconsidering Recent Stroke Guidelines |
| title_fullStr | Role of Blood Lipid Levels and Lipid-Lowering Therapy in Stroke Patients with Different Levels of Cerebral Artery Diseases: Reconsidering Recent Stroke Guidelines |
| title_full_unstemmed | Role of Blood Lipid Levels and Lipid-Lowering Therapy in Stroke Patients with Different Levels of Cerebral Artery Diseases: Reconsidering Recent Stroke Guidelines |
| title_short | Role of Blood Lipid Levels and Lipid-Lowering Therapy in Stroke Patients with Different Levels of Cerebral Artery Diseases: Reconsidering Recent Stroke Guidelines |
| title_sort | role of blood lipid levels and lipid lowering therapy in stroke patients with different levels of cerebral artery diseases reconsidering recent stroke guidelines |
| topic | lipids hydroxymethylglutaryl-coa reductase inhibitors stroke |
| url | http://www.j-stroke.org/upload/pdf/jos-2021-01249.pdf |
| work_keys_str_mv | AT jongskim roleofbloodlipidlevelsandlipidloweringtherapyinstrokepatientswithdifferentlevelsofcerebralarterydiseasesreconsideringrecentstrokeguidelines |