Subsequent vascular events after ischemic stroke: The Japan statin treatment against recurrent stroke - Longitudinal

Eiichi Nomura, Akifumi Suzuki, Isao Inoue, Jyoji Nakagawara, Kazuo Takahashi, Tetsuya Takahashi, Yasuhiro Manabe, Chiaki Yokota, Kazunori Okada, Tetsuhiro Nishihara, Yasumasa Yamamoto, Koichi Noda, Shinichi Takahashi, Setsuro Ibayashi, Makoto Takagi, Kazuo Kitagawa, Norio Tanahashi, Masaru Kuriyama, Koichi Hirata, Naohisa HosomiKazuo Minematsu, Shotai Kobayashi, Masayasu Matsumoto

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Background We undertook a multicenter cohort observational study to investigate the frequency and type of subsequent vascular events after an ischemic stroke and to compare the rates of vascular events between patients with and without hyperlipidemia. Methods This nationwide study was conducted in 19 hospitals participating in the Japan Standard Stroke Registry Study. We enrolled ischemic stroke patients, including those with a transient ischemic attack, who had not experienced any vascular events before enrollment after their ischemic stroke events. Each subject was observed prospectively from September 1, 2003, to October 1, 2005, or until a primary end point or death. Primary end points included subsequent fatal or nonfatal vascular events: stroke, angina pectoris, acute myocardial infarction, aortic aneurysm, or arteriosclerosis obliterans. Results A total of 449 patients (mean age, 67.6 years; 64.8% men) were enrolled in this study. Of the 41 vascular events observed during follow-up, 40 were stroke. The median observation period was 568 days. We found that patients with hyperlipidemia had a significantly higher rate of vascular events compared with those without hyperlipidemia according to the Kaplan-Meier method and the log-rank test (P =.013). Hyperlipidemia significantly increased the risk of vascular events (hazard ratio, 2.169 [1.125-4.312]; P =.021) according to the Cox proportional hazard model after adjusting for confounding factors (age, sex, days from ischemic stroke until enrollment, smoking habits, and daily drinking habits). Conclusions This study demonstrated that stroke was the most common subsequent vascular event after ischemic stroke; the study also indicated that hyperlipidemia could be a risk factor for subsequent vascular events after ischemic stroke.

Original languageEnglish
Pages (from-to)473-479
Number of pages7
JournalJournal of Stroke and Cerebrovascular Diseases
Issue number2
Publication statusPublished - 2015 Feb 1
Externally publishedYes


  • Ischemic stroke
  • diabetes mellitus
  • hyperlipidemia
  • hypertension
  • statin

ASJC Scopus subject areas

  • Surgery
  • Rehabilitation
  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine


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