Deans' stroke musings

Changing stroke rehab and research worldwide now.Time is Brain!Just think of all the trillions and trillions of neurons that DIE each day because there are NO effective hyperacute therapies besides tPA(only 12% effective). I have 493 posts on hyperacute therapy, enough for researchers to spend decades proving them out. These are my personal ideas and blog on stroke rehabilitation and stroke research. Do not attempt any of these without checking with your medical provider. Unless you join me in agitating, when you need these therapies they won't be there.

What this blog is for:

Shortly after getting out of the hospital and getting NO information on the process or protocols of stroke rehabilitation and recovery I started searching on the internet and found that no other survivor received useful information. This is an attempt to cover all stroke rehabilitation information that should be readily available to survivors so they can talk with informed knowledge to their medical staff. It's quite disgusting that this information is not available from every stroke association and doctors group.
My back ground story is here:

Monday, January 9, 2017

Greater intensity of statin therapy confers increased mortality benefit

But high-dose statins are against FDA recommendations. Don't researchers have to follow FDA guidelines? Be careful out there.

FDA announces new safety recommendations for high-dose simvastatin Sept. 2015

Greater intensity of statin therapy confers increased mortality benefit

In a retrospective analysis published in JAMA Cardiology, high-intensity statin use was associated with a survival benefit compared with moderate-intensity statin use, especially if maximal doses of high-intensity statins were taken.
The researchers analyzed 509,766 adults aged 21 to 84 years (mean age, 69 years; 499,598 men) with atherosclerotic CVD treated in the Veterans Affairs health care system from April 2013 to April 2014 to assess the relationship between intensity of statin therapy and mortality.
In the cohort, 29.6% of patients were prescribed a high-intensity statin, 45.6% a moderate-intensity statin, 6.7% a low-intensity statin and 18.2% no statins.
After mean follow-up of 492 days, 4% of those prescribed a high-intensity statin died vs. 4.8% of those receiving a moderate-intensity statin, 5.7% of those receiving a low-intensity statin and 6.6% of those receiving no statins (P < .001), Fatima Rodriguez, MD, MPH, from the division of cardiovascular medicine and the Cardiovascular Institute, Stanford University, and colleagues wrote.
When Rodriguez and colleagues adjusted for propensity to receive high-intensity statin therapy, those who received high-intensity statins remained at lower risk for death vs. those who received moderate-intensity statins (adjusted HR = 0.91; 95% CI, 0.88-0.93).
Among patients who had received their first statin prescription within the prior 6 months, the effect of intensity on survival was slightly less (adjusted HR = 0.93; 95% CI, 0.85-1.01), according to the researchers.
The effect of statin intensity on survival was similar in those aged 75 years or younger (HR = 0.9; 95% CI, 0.88-0.93) and in those aged 76 to 84 years (HR = 0.91; 95% CI, 0.87-0.95).

Robert O. Bonow
Among those receiving high-intensity statins, those taking maximal doses had less risk for death compared with those not taking maximal doses (HR = 0.9; 95% CI, 0.87-0.94), the researchers wrote.
Although the relationship between statin intensity and mortality was not seen in randomized controlled trials, “it is ... possible that this study detected a signal not found in the [randomized controlled trials] because of its very large sample size relative to [randomized controlled trials] and because it involves a broader population, including patients older than 75 years,” Robert O. Bonow, MD, MS, editor of JAMA Cardiology, and Clyde W. Yancy, MD, MSc, deputy editor of JAMA Cardiology, wrote in an editor’s note.
Clyde W.Yancy, MD, MSc
Clyde W. Yancy
“We find these findings confirmatory that high-intensity statin therapy when appropriate is beneficial for secondary prevention, and these benefits are seen even in older persons,” Bonow and Yancy, both from Northwestern University Feinberg School of Medicine, wrote. – by Erik Swain
Disclosure: The researchers, Bonow and Yancy report no relevant financial disclosures.

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