For discussion with your doctor. Do you really think your doctor and stroke hospital keep up-to-date on stroke related research? Hell, I probably get at least twenty pieces of stroke research daily and I only can read the abstracts. So your hospital should have a dedicated employee whose only job is to summarize and distribute such research to all therapists and doctors with clear instructions on how to apply such research to get survivors 100% recovered. THAT IS WHAT A COMPETENT STROKE HOSPITAL WOULD BE DOING. Ask your stroke president if they are competent and doing such research implementation. And if not, WHY NOT?
Their reasons for doing nothing?
Laziness? Incompetence? Or just don't care? No leadership? No strategy? Not my job?
I take no prisoners in my focus on survivors, shouldn't your hospital do the same?
Alirocumab may reduce stroke risk without increasing odds of hemorrhage
December 22, 2019
New
data from the ODYSSEY Outcomes trial show that alirocumab is effective
at reducing risk for any stroke without increasing risk for hemorrhagic
stroke.
In a cohort of 18,924 patients with recent ACS and elevated LDL despite intensive statin therapy, alirocumab (Praluent, Sanofi/Regeneron) was effective in reducing the risk for any stroke (HR = 0.72; 95% CI, 0.57-0.91) and ischemic stroke (HR = 0.73; 95% CI, 0.57-0.93), compared with placebo, during a follow-up of 2.8 years. According to the study, these effects were achieved without increasing the patients’ risk for hemorrhagic stroke (HR = 0.83; 95% CI, 0.42-1.65).
Moreover, researchers noted that the effect of alirocumab on stroke appeared greater for patients with higher baseline LDL but found no formal evidence of heterogeneity (P for interaction = .31).
“This analysis of the ODYSSEY Outcomes trial shows that in patients with recent ACS and dyslipidemia despite intensive statin therapy, the PCSK9 inhibitor alirocumab decreased the risk of stroke, irrespective of baseline LDL and of history of cerebrovascular disease, over a median follow-up of 2.8 years,” J. Wouter Jukema, MD, PhD, professor of cardiology in the department of cardiology at Leiden University Medical Center in the Netherlands, and colleagues wrote. “Furthermore, the present findings indicate that the risk of hemorrhagic stroke did not depend on achieved LDL levels in the alirocumab group.”
In other findings, the effect of alirocumab on stroke was similar among individuals with previous cerebrovascular disease and those without (P for interaction = .37).
Alirocumab effect on baseline LDL
In addition, researchers found no adverse relationship between lower achieved LDL and incidence of hemorrhagic stroke in the alirocumab group compared with placebo.
“The treatment effect appeared numerically greater with lower HRs for patients with higher baseline LDL, suggesting that patients with a higher risk at baseline have a larger benefit of alirocumab,” the researchers wrote. “However, this linear trend was not statistically significant.”
In this double-blind trial, researchers randomly assigned patients with ACS and elevated LDL to alirocumab or placebo, with target LDL levels of 25 mg/dL to 50 mg/dL, avoiding sustained levels below 15 mg/dL. Patients were randomly assigned to alirocumab or placebo 1 to 12 months after ACS. The aim of this analysis was to evaluate nonfatal, fatal ischemic or hemorrhagic stroke and stratified by baseline LDL level and prior cerebrovascular disease. As Healio previously reported, in the main results of ODYSSEY Outcomes, alirocumab reduced risk for major adverse CV events by 15% compared with placebo in this population.
In a cohort of 18,924 patients with recent ACS and elevated LDL despite intensive statin therapy, alirocumab (Praluent, Sanofi/Regeneron) was effective in reducing the risk for any stroke (HR = 0.72; 95% CI, 0.57-0.91) and ischemic stroke (HR = 0.73; 95% CI, 0.57-0.93), compared with placebo, during a follow-up of 2.8 years. According to the study, these effects were achieved without increasing the patients’ risk for hemorrhagic stroke (HR = 0.83; 95% CI, 0.42-1.65).
“This analysis of the ODYSSEY Outcomes trial shows that in patients with recent ACS and dyslipidemia despite intensive statin therapy, the PCSK9 inhibitor alirocumab decreased the risk of stroke, irrespective of baseline LDL and of history of cerebrovascular disease, over a median follow-up of 2.8 years,” J. Wouter Jukema, MD, PhD, professor of cardiology in the department of cardiology at Leiden University Medical Center in the Netherlands, and colleagues wrote. “Furthermore, the present findings indicate that the risk of hemorrhagic stroke did not depend on achieved LDL levels in the alirocumab group.”
In other findings, the effect of alirocumab on stroke was similar among individuals with previous cerebrovascular disease and those without (P for interaction = .37).
Alirocumab effect on baseline LDL
In addition, researchers found no adverse relationship between lower achieved LDL and incidence of hemorrhagic stroke in the alirocumab group compared with placebo.
“The treatment effect appeared numerically greater with lower HRs for patients with higher baseline LDL, suggesting that patients with a higher risk at baseline have a larger benefit of alirocumab,” the researchers wrote. “However, this linear trend was not statistically significant.”
In this double-blind trial, researchers randomly assigned patients with ACS and elevated LDL to alirocumab or placebo, with target LDL levels of 25 mg/dL to 50 mg/dL, avoiding sustained levels below 15 mg/dL. Patients were randomly assigned to alirocumab or placebo 1 to 12 months after ACS. The aim of this analysis was to evaluate nonfatal, fatal ischemic or hemorrhagic stroke and stratified by baseline LDL level and prior cerebrovascular disease. As Healio previously reported, in the main results of ODYSSEY Outcomes, alirocumab reduced risk for major adverse CV events by 15% compared with placebo in this population.
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