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학술저널
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대한신경과학회 Journal of Clinical Neurology Journal of Clinical Neurology 제9권 제3호
발행연도
2013.1
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139 - 143 (5page)

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Background and Purpose Treatment with atorvastatin (80 mg) in stroke secondary prevention for patients with prior intracranial hemorrhage (ICH) has been associated with a higher frequency of ICH. The aim of this study was to determine whether 20 mg/day atorvastatin is linked to stroke recurrence in Chinese ischemic stroke patients with prior ICH. Methods A single-center retrospective cohort study was conducted, involving 354 cases from 395 Chinese in-patients who had ischemic stroke with prior ICH history in Beijing Chaoyang hospital from May 1, 2005 to October 31, 2010. Survivors were followed by telephone interviews for 12-60 months. Cox regression and Kaplan-Meier plot analysis were used to evaluate the effect of 20 mg/day atorvastatin on cerebral infarction and ICH recurrence. Results The overall rate of stroke recurrence was lower in the 20 mg/day atorvastatin group(χ2=6.687, p=0.022) than in the control group. The incidence of cerebral hemorrhage was increased by 20 mg/day atorvastatin for ischemic stroke cases with a history of ICH compared tothose not receiving the drug, but the difference was not significant [hazard ratio (HR)=1.097,95% confidence interval (CI)=0.800-1.243, p=0.980]. The incidence of ischemic stroke recurrence was significantly reduced in subjects receiving atorvastatin (HR=0.723, 95% CI=0.578-0.862, p=0.028), and the mean duration of all stroke recurrences was significantly prolonged,compared with those not exposed to the drug (χ2=5.351, p=0.021). The mean duration of ICH recurrence appeared to have shortened with atorvastatin, but the difference was not significant (χ2=0.680, p=0.480), and the mean duration of cerebral infarction recurrence was significantly prolonged (χ2=8.312, p=0.004). Conclusions Medication with 20 mg/day atorvastatin may be beneficial in reducing ischemic stroke recurrence in ischemic stroke patients with a history of ICH and is not associated with an increased risk of ICH recurrence.
#ischemic stroke #intracranial hemorrhage history #atorvastatin #stroke recurrence.

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참고문헌 (21)

참고문헌 신청
Alessandro Biffi / 2011 / Cerebral Amyloid Angiopathy: A Systematic Review / Journal of Clinical Neurology 7 (1) : 1 ~ 9 google schola Amarenco P / 2006 / High-dose atorvastatin after stroke or transient ischemic attack / The New England Journal of Medicine 355 : 549 ~ 559 google schola Bushnell CD / 2006 / Statin use and sex-specific stroke outcomes in patients with vascular disease / Stroke 37 : 1427 ~ 1431 google schola Coutts SB / 2005 / Silent ischemia in minor stroke and TIA patients identified on MR imaging / Neurology 65 : 513 ~ 517 google schola Elkind MS / 2005 / Lipid-lowering agent use at ischemic stroke onset is associated with decreased mortality / Neurology 65 : 253 ~ 258 google schola

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