دورية أكاديمية
The Influence of Non-High-Density Lipoprotein Cholesterol on the Efficacy of Genotype-Guided Dual Antiplatelet Therapy in Preventing Stroke Recurrence
| العنوان: | The Influence of Non-High-Density Lipoprotein Cholesterol on the Efficacy of Genotype-Guided Dual Antiplatelet Therapy in Preventing Stroke Recurrence |
|---|---|
| المؤلفون: | Qin Xu, Xia Meng, Hao Li, Xuewei Xie, Jing Jing, Jinxi Lin, Yong Jiang, Yilong Wang, Xingquan Zhao, Zixiao Li, Liping Liu, Anxin Wang, Yongjun Wang |
| المصدر: | Journal of Stroke, Vol 26, Iss 2, Pp 231-241 (2024) |
| بيانات النشر: | Korean Stroke Society, 2024. |
| سنة النشر: | 2024 |
| المجموعة: | LCC:Diseases of the circulatory (Cardiovascular) system |
| مصطلحات موضوعية: | chance-2, stroke, ticagrelor, clopidogrel, non–high-density lipoprotein cholesterol, Diseases of the circulatory (Cardiovascular) system, RC666-701 |
| الوصف: | Background and Purpose Non-high-density lipoprotein cholesterol (non-HDL-C), which represents the total cholesterol content of all pro-atherogenic lipoproteins, has recently been included as a new target for lipid-lowering therapy in high-risk atherosclerotic patients in multiple guidelines. Herein, we aimed to explore the relationship between non-HDL-C level and the efficacy and safety of ticagrelor-aspirin versus clopidogrel-aspirin in preventing stroke recurrence. Methods This study comprised a post hoc analysis of the CHANCE-2 (Ticagrelor or Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events II) trial, from which 5,901 patients with complete data on non-HDL-C were included and categorized by median non-HDL-C levels, using a cutoff of 3.5 mmol/L. The primary efficacy and safety outcomes were recurrent stroke and severe or moderate bleeding within 90 days. Results Ticagrelor-aspirin significantly reduced the risk of recurrent stroke in patients with low non-HDL-C (71 [4.8%] vs. 119 [7.7%]; adjusted hazard ratio [HR] 0.54; 95% confidence interval [CI], 0.40–0.74), but not in those with high non-HDL-C (107 [7.3%] vs. 108 [7.6%]; adjusted HR, 0.88; 95% CI, 0.67–1.16), compared with clopidogrel-aspirin (P for interaction=0.010). When analyzed as a continuous variable, the benefit of ticagrelor-aspirin for recurrent stroke decreased as non-HDL-C levels increased. No significant differences in the treatment assignments across the non-HDL-C groups were observed in terms of the rate of severe or moderate bleeding (5 [0.3%] vs. 8 [0.5%] in the low non-HDL-C group; 4 [0.3%] vs. 2 [0.1%] in the high non-HDL-C group; P for interaction=0.425). Conclusion CHANCE-2 participants with low non-HDL-C levels received more clinical benefit from ticagrelor-aspirin versus clopidogrel-aspirin compared to those with high non-HDL-C, following minor ischemic stroke or transient ischemic attack. |
| نوع الوثيقة: | article |
| وصف الملف: | electronic resource |
| اللغة: | English |
| تدمد: | 2287-6391 2287-6405 |
| العلاقة: | http://www.j-stroke.org/upload/pdf/jos-2024-00367.pdfTest; https://doaj.org/toc/2287-6391Test; https://doaj.org/toc/2287-6405Test |
| DOI: | 10.5853/jos.2024.00367 |
| الوصول الحر: | https://doaj.org/article/1fdda556980f405982e7d2dcb6a3dacaTest |
| رقم الانضمام: | edsdoj.1fdda556980f405982e7d2dcb6a3daca |
| قاعدة البيانات: | Directory of Open Access Journals |
Full Text Finder | تدمد: | 22876391 22876405 |
|---|---|
| DOI: | 10.5853/jos.2024.00367 |