Statin therapy in acute cardioembolic stroke with no guidance-based indication

Objective It is uncertain if patients with cardioembolic stroke and absence of a guidance-based indication for statin therapy should be administered a statin for prevention of subsequent vascular events. This study was performed to determine whether the statin therapy is beneficial to prevent major vascular events in this population. Methods Using a prospective multicenter stroke registry database, we identified acute cardioembolic stroke patients who were hospitalized between 2008 and 2015. Patients who had other established indications for statin therapy according to current guideline were excluded. Major vascular event was defined as a composite of stroke recurrence, myocardial infarction and vascular death. We performed frailty model analysis with the robust sandwich variance estimator using the stabilized inverse probability of treatment weighting method to estimate hazard ratios of statin therapy on outcomes. Results Of 6,124 cardioembolic stroke patients, 2,888 (male, 44.6%...研究目的：目前尚不明确，对于心源性卒中（cardioembolic stroke）且无他汀类药物治疗（statin therapy）指南推荐指征（guidance-based indication）的患者，是否应给予他汀类药物以预防后续血管事件。本研究旨在明确他汀类药物治疗对该人群预防主要血管事件是否具有临床获益。 研究方法：本研究依托前瞻性多中心卒中登记数据库，纳入2008年至2015年住院的急性心源性卒中患者。排除符合当前指南明确他汀类药物治疗指征的患者。主要血管事件定义为卒中复发、心肌梗死及血管性死亡的复合终点。本研究采用稳定治疗逆概率加权（stabilized inverse probability of treatment weighting）法结合稳健三明治方差估计量（robust sandwich variance estimator）进行脆弱模型（frailty model）分析，以估算他汀类药物治疗对研究结局的风险比（hazard ratios）。 研究结果：共纳入6124例心源性卒中患者，其中2888例（男性占比44.6%……