Association between statin therapy and the risk of stroke in patients with moyamoya disease:a nationwide cohort study

作     者：Joonsang Yoo Jimin Jeon Minyoul Baik Jinkwon Kim 

作者机构：Department of NeurologyYongin Severance HospitalYonsei College of MedicineYongin-siKorea(the Republic of) Institute for Innovation in Digital HealthcareYonsei UniversitySeoulKorea(the Republic of) 

出 版 物：《Stroke & Vascular Neurology》 (卒中与血管神经病学(英文))

年 卷 期：2023年第8卷第4期

页      面：276-283,I0010-I0021页

核心收录：

学科分类：1002[医学-临床医学] 100204[医学-神经病学] 10[医学] 

基　　金：supported by the Chong Kun Dang pharmaceutical and Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Education(NRF-2021R1I1A1A0104944111) 

主　　题：patients diagnosis nationwide 

摘      要：Background and objective Knowledge regarding the pharmacological treatment for moyamoya disease(MMD),a chronic and progressive cerebrovascular disease conferring greater stroke risk,is *** the present study,whether statin therapy is associated with a reduced risk of stroke in patients with MMD was *** This was a retrospective cohort study in which the occurrence of stroke in patients with newly diagnosed MMD was investigated using the nationwide health insurance database in Korea from January 2007 to March 2021.A multivariable Cox proportional hazards regression model was constructed for stroke,in which statin therapy after MMD diagnosis was treated as a time-dependent *** was done for sex,age,presence of comorbidities,concurrent stroke,revascularisation surgery and treatment with *** The present study included 13373 newly diagnosed patients with MMD;40.8%had a concurrent stroke at the time of MMD *** the mean follow-up of 5.1±3.3 years,631 patients(4.7%)suffered a stroke event(haemorrhagic stroke:458 patients,ischaemic stroke:173 patients).Statin therapy after MMD diagnosis was significantly associated with a reduced risk of stroke(adjusted HR 0.74;95%CI 0.60 to 0.91,p=0.004).In the secondary outcome analysis,the risk of haemorrhagic stroke(adjusted HR 0.74;95%CI 0.58 to 0.95,p=0.018)and ischaemic stroke(adjusted HR 0.75;95%CI 0.52 to 1.08,p=0.124)were reduced with the statin *** statins was also associated with a lower risk of all-cause mortality(adjusted HR 0.47;95%CI 0.33 to 0.67,p0.001).Conclusion In patients with MMD,statin therapy was associated with a reduced risk of subsequent *** findings indicate statin treatment may be beneficial for patients with MMD,however the results should be confirmed in randomised controlled trials.