Comparative Effectiveness of Rosuvastatin Versus Atorvastatin in Acute Ischemic Stroke Treatment
Background Research specifically addressing the efficacy of rosuvastatin versus atorvastatin in patients with ischemic stroke is insufficient. Using a large stroke registry, we investigated whether 2 commonly used statins, rosuvastatin and atorvastatin, differ in their effectiveness in reducing the...
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2025-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.124.038080 |
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| author | Joon‐Tae Kim Ji Sung Lee Hyunsoo Kim Beom Joon Kim Jihoon Kang Keon‐Joo Lee Jong‐Moo Park Kyusik Kang Soo Joo Lee Jae Guk Kim Jae‐Kwan Cha Dae‐Hyun Kim Tai Hwan Park Kyungbok Lee Jun Lee Keun‐Sik Hong Yong‐Jin Cho Hong‐Kyun Park Byung‐Chul Lee Kyung‐Ho Yu Mi Sun Oh Dong‐Eog Kim Jay Chol Choi Jee‐Hyun Kwon Wook‐Joo Kim Dong‐Ick Shin Kyu Sun Yum Sung Il Sohn Jeong‐Ho Hong Sang‐Hwa Lee Man‐Seok Park Wi‐Sun Ryu Kwang‐Yeol Park Juneyoung Lee Jeffrey L. Saver Hee‐Joon Bae |
| author_facet | Joon‐Tae Kim Ji Sung Lee Hyunsoo Kim Beom Joon Kim Jihoon Kang Keon‐Joo Lee Jong‐Moo Park Kyusik Kang Soo Joo Lee Jae Guk Kim Jae‐Kwan Cha Dae‐Hyun Kim Tai Hwan Park Kyungbok Lee Jun Lee Keun‐Sik Hong Yong‐Jin Cho Hong‐Kyun Park Byung‐Chul Lee Kyung‐Ho Yu Mi Sun Oh Dong‐Eog Kim Jay Chol Choi Jee‐Hyun Kwon Wook‐Joo Kim Dong‐Ick Shin Kyu Sun Yum Sung Il Sohn Jeong‐Ho Hong Sang‐Hwa Lee Man‐Seok Park Wi‐Sun Ryu Kwang‐Yeol Park Juneyoung Lee Jeffrey L. Saver Hee‐Joon Bae |
| author_sort | Joon‐Tae Kim |
| collection | DOAJ |
| description | Background Research specifically addressing the efficacy of rosuvastatin versus atorvastatin in patients with ischemic stroke is insufficient. Using a large stroke registry, we investigated whether 2 commonly used statins, rosuvastatin and atorvastatin, differ in their effectiveness in reducing the risk of vascular events in patients with acute ischemic stroke. Methods We analyzed data from a nationwide stroke registry in South Korea between January 2011 and April 2022. Patients with acute ischemic stroke within 7 days of onset who were prescribed either atorvastatin or rosuvastatin at discharge were included. The primary outcome was a composite of recurrent stroke (either hemorrhagic or ischemic), myocardial infarction, and all‐cause mortality within 1 year. Results A total of 43 512 patients (age, 69.2±12.5 years; male, 59.8%) were analyzed in this study. Atorvastatin was used in 84.8% (n=36 903), and rosuvastatin was used in 15.2% (n=6609). The 1‐year cumulative event rate of the composite of recurrent stroke, myocardial infarction, and all‐cause mortality was significantly lower in the rosuvastatin group than in the atorvastatin group (9.7% [95% CI, 9.0–10.5] versus 10.7% [95% CI, 10.4–11.0]; P=0.049). Cox proportional hazards analysis revealed that rosuvastatin, compared with atorvastatin, was significantly associated with less risk of 1‐year composite of recurrent stroke, myocardial infarction, and all‐cause mortality, with an absolute risk reduction of 1% [95% CI, −1.8 to −0.2] and a relative risk reduction of 11% (hazard ratio, 0.89 [95% CI, 0.82–0.97]). However, there were discrepancies in the statistical significance of the results between the propensity score matching and stabilized inverse probability of treatment weighting analysis. Conclusions The results of this analysis of a large cohort of patients with ischemic stroke suggested that, compared with atorvastatin, rosuvastatin was significantly associated with a reduced risk of a 1‐year composite of recurrent stroke, myocardial infarction, and all‐cause mortality in patients with acute ischemic stroke. However, in real clinical practice, rosuvastatin is used less than one‐fifth as frequently as atorvastatin in patients with acute ischemic stroke. This study serves as a hypothesis‐generating function. |
| format | Article |
| id | doaj-art-35eea9762f5b4495bcfc6a480d9e1310 |
| institution | Kabale University |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-35eea9762f5b4495bcfc6a480d9e13102025-02-04T11:00:01ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-02-0114310.1161/JAHA.124.038080Comparative Effectiveness of Rosuvastatin Versus Atorvastatin in Acute Ischemic Stroke TreatmentJoon‐Tae Kim0Ji Sung Lee1Hyunsoo Kim2Beom Joon Kim3Jihoon Kang4Keon‐Joo Lee5Jong‐Moo Park6Kyusik Kang7Soo Joo Lee8Jae Guk Kim9Jae‐Kwan Cha10Dae‐Hyun Kim11Tai Hwan Park12Kyungbok Lee13Jun Lee14Keun‐Sik Hong15Yong‐Jin Cho16Hong‐Kyun Park17Byung‐Chul Lee18Kyung‐Ho Yu19Mi Sun Oh20Dong‐Eog Kim21Jay Chol Choi22Jee‐Hyun Kwon23Wook‐Joo Kim24Dong‐Ick Shin25Kyu Sun Yum26Sung Il Sohn27Jeong‐Ho Hong28Sang‐Hwa Lee29Man‐Seok Park30Wi‐Sun Ryu31Kwang‐Yeol Park32Juneyoung Lee33Jeffrey L. Saver34Hee‐Joon Bae35Department of Neurology Chonnam National University Hospital, Chonnam National University Medical School Gwangju KoreaClinical Research Center Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine Seoul KoreaDepartment of Neurology Chonnam National University Hospital, Chonnam National University Medical School Gwangju KoreaDepartment of Neurology Seoul National University College of Medicine, Seoul National University Bundang Hospital Seongnam KoreaDepartment of Neurology Seoul National University College of Medicine, Seoul National University Bundang Hospital Seongnam KoreaDepartment of Neurology Korea University Guro Hospital Seoul KoreaDepartment of Neurology Uijeongbu Eulji Medical Center, Eulji University School of Medicine Uijeongbu‐si KoreaDepartment of Neurology Nowon Eulji Medical Center, Eulji University School of Medicine Seoul KoreaDepartment of Neurology Daejeon Eulji Medical Center, Eulji University School of Medicine Daejeon KoreaDepartment of Neurology Daejeon Eulji Medical Center, Eulji University School of Medicine Daejeon KoreaDepartment of Neurology Dong‐A University Hospital Busan KoreaDepartment of Neurology Dong‐A University Hospital Busan KoreaDepartment of Neurology Seoul Medical Center Seoul KoreaDepartment of Neurology Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine Seoul KoreaDepartment of Neurology Yeungnam University Hospital Daegu KoreaDepartment of Neurology Ilsan Paik Hospital, Inje University Goyang KoreaDepartment of Neurology Ilsan Paik Hospital, Inje University Goyang KoreaDepartment of Neurology Ilsan Paik Hospital, Inje University Goyang KoreaDepartment of Neurology Hallym University Sacred Heart Hospital Anyang KoreaDepartment of Neurology Hallym University Sacred Heart Hospital Anyang KoreaDepartment of Neurology Hallym University Sacred Heart Hospital Anyang KoreaDepartment of Neurology Dongguk University Ilsan Hospital Goyang KoreaDepartment of Neurology Jeju National University Hospital, Jeju National University School of Medicine Jeju KoreaDepartment of Neurology Ulsan University College of Medicine Ulsan KoreaDepartment of Neurology Ulsan University College of Medicine Ulsan KoreaDepartment of Neurology Chungbuk National University Hospital Cheongju KoreaDepartment of Neurology Chungbuk National University Hospital Cheongju KoreaDepartment of Neurology Keimyung University Dongsan Medical Center Daegu KoreaDepartment of Neurology Keimyung University Dongsan Medical Center Daegu KoreaDepartment of Neurology Hallym University Chuncheon Sacred Heart Hospital Chuncheon‐si Gangwon‐do KoreaDepartment of Neurology Chonnam National University Hospital, Chonnam National University Medical School Gwangju KoreaArtificial Intelligence Research Center JLK Inc. Seoul KoreaDepartment of Neurology Chung‐Ang University College of Medicine, Chung‐Ang University Hospital Seoul KoreaDepartment of Biostatistics Korea University College of Medicine Seoul KoreaDepartment of Neurology and Comprehensive Stroke Center, David Geffen School of Medicine University of California Los Angeles CADepartment of Neurology Seoul National University College of Medicine, Seoul National University Bundang Hospital Seongnam KoreaBackground Research specifically addressing the efficacy of rosuvastatin versus atorvastatin in patients with ischemic stroke is insufficient. Using a large stroke registry, we investigated whether 2 commonly used statins, rosuvastatin and atorvastatin, differ in their effectiveness in reducing the risk of vascular events in patients with acute ischemic stroke. Methods We analyzed data from a nationwide stroke registry in South Korea between January 2011 and April 2022. Patients with acute ischemic stroke within 7 days of onset who were prescribed either atorvastatin or rosuvastatin at discharge were included. The primary outcome was a composite of recurrent stroke (either hemorrhagic or ischemic), myocardial infarction, and all‐cause mortality within 1 year. Results A total of 43 512 patients (age, 69.2±12.5 years; male, 59.8%) were analyzed in this study. Atorvastatin was used in 84.8% (n=36 903), and rosuvastatin was used in 15.2% (n=6609). The 1‐year cumulative event rate of the composite of recurrent stroke, myocardial infarction, and all‐cause mortality was significantly lower in the rosuvastatin group than in the atorvastatin group (9.7% [95% CI, 9.0–10.5] versus 10.7% [95% CI, 10.4–11.0]; P=0.049). Cox proportional hazards analysis revealed that rosuvastatin, compared with atorvastatin, was significantly associated with less risk of 1‐year composite of recurrent stroke, myocardial infarction, and all‐cause mortality, with an absolute risk reduction of 1% [95% CI, −1.8 to −0.2] and a relative risk reduction of 11% (hazard ratio, 0.89 [95% CI, 0.82–0.97]). However, there were discrepancies in the statistical significance of the results between the propensity score matching and stabilized inverse probability of treatment weighting analysis. Conclusions The results of this analysis of a large cohort of patients with ischemic stroke suggested that, compared with atorvastatin, rosuvastatin was significantly associated with a reduced risk of a 1‐year composite of recurrent stroke, myocardial infarction, and all‐cause mortality in patients with acute ischemic stroke. However, in real clinical practice, rosuvastatin is used less than one‐fifth as frequently as atorvastatin in patients with acute ischemic stroke. This study serves as a hypothesis‐generating function.https://www.ahajournals.org/doi/10.1161/JAHA.124.038080acute isc hemic strokeatorvastatinrosuvastatin |
| spellingShingle | Joon‐Tae Kim Ji Sung Lee Hyunsoo Kim Beom Joon Kim Jihoon Kang Keon‐Joo Lee Jong‐Moo Park Kyusik Kang Soo Joo Lee Jae Guk Kim Jae‐Kwan Cha Dae‐Hyun Kim Tai Hwan Park Kyungbok Lee Jun Lee Keun‐Sik Hong Yong‐Jin Cho Hong‐Kyun Park Byung‐Chul Lee Kyung‐Ho Yu Mi Sun Oh Dong‐Eog Kim Jay Chol Choi Jee‐Hyun Kwon Wook‐Joo Kim Dong‐Ick Shin Kyu Sun Yum Sung Il Sohn Jeong‐Ho Hong Sang‐Hwa Lee Man‐Seok Park Wi‐Sun Ryu Kwang‐Yeol Park Juneyoung Lee Jeffrey L. Saver Hee‐Joon Bae Comparative Effectiveness of Rosuvastatin Versus Atorvastatin in Acute Ischemic Stroke Treatment Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease acute isc hemic stroke atorvastatin rosuvastatin |
| title | Comparative Effectiveness of Rosuvastatin Versus Atorvastatin in Acute Ischemic Stroke Treatment |
| title_full | Comparative Effectiveness of Rosuvastatin Versus Atorvastatin in Acute Ischemic Stroke Treatment |
| title_fullStr | Comparative Effectiveness of Rosuvastatin Versus Atorvastatin in Acute Ischemic Stroke Treatment |
| title_full_unstemmed | Comparative Effectiveness of Rosuvastatin Versus Atorvastatin in Acute Ischemic Stroke Treatment |
| title_short | Comparative Effectiveness of Rosuvastatin Versus Atorvastatin in Acute Ischemic Stroke Treatment |
| title_sort | comparative effectiveness of rosuvastatin versus atorvastatin in acute ischemic stroke treatment |
| topic | acute isc hemic stroke atorvastatin rosuvastatin |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.124.038080 |
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