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Dyslipidemia Treatment and Cerebrovascular Disease: Evidence Regarding the Mechanism of Stroke

김범준|Ha Sang Hee
한국지질동맥경화학회 (The Korean Society of Lipidology and Atherosclerosis)|2024.05|지질·동맥경화학회지 (Journal of Lipid and Atherosclerosis)|제13권 제2호|pp. 139-154|DOI 10.12997/jla.2024.13.2.139

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키워드

StrokesecondaryDyslipidemiaDisease preventionLow-density lipoprotein

초록

Dyslipidemia stands as a significant risk factor for stroke, on par with the impact of hypertension, diabetes, and smoking. While the role of dyslipidemia is firmly established in the context of coronary artery disease, its influence on strokes remains somewhat enigmatic. This complexity likely arises from the diverse mechanisms underpinning strokes, which encompass a heterogeneous spectrum (hemorrhagic and ischemic; large artery atherosclerosis, small vessel occlusion, cardioembolism, and etc.). The extent to which lipid-lowering treatments affect stroke outcomes may vary depending on the specific stroke subtype. For instance, in cases of large artery atherosclerosis (LAA), the optimal target level of low-density lipoprotein cholesterol (LDL-C) is relatively clear. However, when dealing with other stroke subtypes like small vessel occlusion or cardioembolism, the appropriate LDL-C target remains uncertain. Furthermore, reperfusion therapy has emerged as the foremost treatment for acute ischemic stroke. Nevertheless, the precise relationship between LDL-C levels and outcomes in patients undergoing reperfusion therapy remains shrouded in uncertainty. Consequently, we have undertaken an in-depth exploration of the existing evidence supporting the utilization of lipid-lowering medications such as statins, ezetimibe, and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. Our objective is to elucidate their role in secondary stroke prevention and the management of dyslipidemia across the various stroke subtypes.

Abstract

Dyslipidemia stands as a significant risk factor for stroke, on par with the impact of hypertension, diabetes, and smoking. While the role of dyslipidemia is firmly established in the context of coronary artery disease, its influence on strokes remains somewhat enigmatic. This complexity likely arises from the diverse mechanisms underpinning strokes, which encompass a heterogeneous spectrum (hemorrhagic and ischemic; large artery atherosclerosis, small vessel occlusion, cardioembolism, and etc.). The extent to which lipid-lowering treatments affect stroke outcomes may vary depending on the specific stroke subtype. For instance, in cases of large artery atherosclerosis (LAA), the optimal target level of low-density lipoprotein cholesterol (LDL-C) is relatively clear. However, when dealing with other stroke subtypes like small vessel occlusion or cardioembolism, the appropriate LDL-C target remains uncertain. Furthermore, reperfusion therapy has emerged as the foremost treatment for acute ischemic stroke. Nevertheless, the precise relationship between LDL-C levels and outcomes in patients undergoing reperfusion therapy remains shrouded in uncertainty. Consequently, we have undertaken an in-depth exploration of the existing evidence supporting the utilization of lipid-lowering medications such as statins, ezetimibe, and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors. Our objective is to elucidate their role in secondary stroke prevention and the management of dyslipidemia across the various stroke subtypes.

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관련 논문AI추천

Role of Blood Lipid Levels and Lipid-Lowering Therapy in Stroke Patients with Different Levels of Cerebral Artery Diseases: Reconsidering Recent Stroke GuidelinesJong S. Kim대한뇌졸중학회 · 대한뇌졸중영문학회지2021 · 제23권 제2호뇌졸중 이후의 이상지혈증의 관리송태진, 장윤경대한신경과학회 · 대한신경과학회지2022 · 제40권 제3호Hypertriglyceridemia: A Neglected Risk Factor for Ischemic Stroke?Guo-qing Liu, Hai-jie Liang, Qing-yi Zhang, Rong Qi, Yi-tong Hu대한뇌졸중학회 · 대한뇌졸중영문학회지2022 · 제24권 제1호Optimal Low-Density Lipoprotein Cholesterol Level: Time to Reconsider Stroke SubtypesJong S. Kim대한뇌졸중학회 · 대한뇌졸중영문학회지2025 · 제27권 제2호Recent Advances in Primary and Secondary Prevention of Atherosclerotic Stroke김동억, Andrei V. Alexandrov, Apostolos Safouris, Georgios Tsivgoulis대한뇌졸중학회 · 대한뇌졸중영문학회지2018 · 제20권 제2호Statins in Acute Ischemic Stroke: A Systematic ReviewJi Sung Lee, Keun-Sik Hong대한뇌졸중학회 · 대한뇌졸중영문학회지2015 · 제17권 제3호

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