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Inducers and Cardiovascular Risk —Potential Role for Lowered Drug Exposure—Reply
In Reply We thank Van der Linden and colleagues for their interest in our article, which describes the long-term cardiovascular risk associated with continued use of enzyme-inducing antiseizure medications (eiASMs). With respect to our mediation analysis, we considered incident dyslipidemia as a binary mediator variable, as opposed to a continuous variable of low-density lipoprotein cholesterol or total cholesterol, given its direct clinical relevance as the threshold over which treatment is initiated. However, we agree that future efforts at exploring a dose-dependent mediation between absolute and relative increases in l...
Source: JAMA Neurology - March 7, 2022 Category: Neurology Source Type: research

Low-Density Lipoprotein Cholesterol Level After a Stroke
Randomized clinical trials (RCTs) of statins as the primary prevention for patients with a high serum low-density lipoprotein cholesterol (LDL-C) level and as the secondary prevention after an acute coronary event have shown that lowering serum LDL-C levels reduces the risks of myocardial infarction, stroke, and vascular death. These trials included stroke as a secondary end point but not as an entry criterion. The benefit of LDL-C lowering to reduce the risk of ischemic strokes in primary prevention trials and for patients with coronary heart disease is not necessarily seen among patients who have had a stroke. The Stroke...
Source: JAMA Neurology - February 21, 2022 Category: Neurology Source Type: research

Intensity of LDL Cholesterol Lowering and Secondary Stroke Prevention
This meta-analysis of randomized clinical trials evaluates the association of more intensive vs less intensive low-density lipoprotein cholesterol –lowering statin-based therapies with outcomes for patients with ischemic stroke.
Source: JAMA Neurology - February 21, 2022 Category: Neurology Source Type: research

A Promising Skills-Based Intervention to Reduce Blood Pressure in Individuals With Stroke and Transient Ischemic Attack
Globally, stroke is the second leading cause of death and third leading cause of disability. More than 74% of the burden of stroke has been attributed to smoking, poor diet, and low physical activity, while more than 72% has been attributed to metabolic risk factors (high plasma glucose, high cholesterol, high blood pressure, overweight and obesity, and kidney disease). These are all risk factors that are modifiable with appropriate treatment or change in lifestyle behaviors.
Source: JAMA Neurology - October 8, 2018 Category: Neurology Source Type: research

Keeping Faith With Patients After Stroke or Transient Ischemic Attack
I recently recommended statin therapy to a 68-year-old patient, explaining that it would reduce his risk of a major coronary event or stroke in the next 10 years from 18% to 15%. He asked, “But how will we know if it works?” I confessed we never would because success would be an uneventful walk through good health. He was not sold.
Source: JAMA Neurology - February 5, 2018 Category: Neurology Source Type: research

Cerebral Microbleeds and Early Recurrent Stroke After Transient Ischemic Attack Results from the Korean Transient Ischemic Attack Expression Registry
Conclusions and RelevanceImmediate and optimal management seems to modify the risk of recurrent stroke after TIA. Cerebral microbleeds may be novel predictors of stroke recurrence, which needs further validation.
Source: JAMA Neurology - January 12, 2015 Category: Neurology Source Type: research