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학제간연구 과학기술학 뇌인지과학 기술정책 기타 복합학

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논문 기본 정보

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학술저널
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Qin Xu (Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China China National Clinical Research Center for Neurological Diseases, Beijing, China Department of) Xia Meng (Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China China National Clinical Research Center for Neurological Diseases, Beijing, China Department of) Hao Li (Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China China National Clinical Research Center for Neurological Diseases, Beijing, China) Xuewei Xie (Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China China National Clinical Research Center for Neurological Diseases, Beijing, China) Jing Jing (Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China China National Clinical Research Center for Neurological Diseases, Beijing, China) Jinxi Lin (Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China China National Clinical Research Center for Neurological Diseases, Beijing, China) Yong Jiang (Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China China National Clinical Research Center for Neurological Diseases, Beijing, China) Yilong Wang (Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China China National Clinical Research Center for Neurological Diseases, Beijing, China Department of) Xingquan Zhao (Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China China National Clinical Research Center for Neurological Diseases, Beijing, China) Zixiao Li (Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China China National Clinical Research Center for Neurological Diseases, Beijing, China) Liping Liu (Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China China National Clinical Research Center for Neurological Diseases, Beijing, China) Anxin Wang (Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China China National Clinical Research Center for Neurological Diseases, Beijing, China Department of) Yongjun Wang (Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China China National Clinical Research Center for Neurological Diseases, Beijing, China Department of)
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대한뇌졸중학회 대한뇌졸중학회지 대한뇌졸중영문학회지 제26권 제2호
발행연도
2024.5
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231 - 241 (11page)

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Background and Purpose Non-high-density lipoprotein cholesterol (non-HDL-C), which represents the total cholesterol content of all pro-atherogenic lipoproteins, has recently been included as a new target for lipid-lowering therapy in high-risk atherosclerotic patients in multiple guidelines. Herein, we aimed to explore the relationship between non-HDL-C level and the efficacy and safety of ticagrelor-aspirin versus clopidogrel-aspirin in preventing stroke recurrence. Methods This study comprised a post hoc analysis of the CHANCE-2 (Ticagrelor or Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events II) trial, from which 5,901 patients with complete data on non-HDL-C were included and categorized by median non-HDL-C levels, using a cutoff of 3.5 mmol/L. The primary efficacy and safety outcomes were recurrent stroke and severe or moderate bleeding within 90 days. Results Ticagrelor-aspirin significantly reduced the risk of recurrent stroke in patients with low non-HDL-C (71 [4.8%] vs. 119 [7.7%]; adjusted hazard ratio [HR] 0.54; 95% confidence interval [CI], 0.40–0.74), but not in those with high non-HDL-C (107 [7.3%] vs. 108 [7.6%]; adjusted HR, 0.88; 95% CI, 0.67–1.16), compared with clopidogrel-aspirin (P for interaction=0.010). When analyzed as a continuous variable, the benefit of ticagrelor-aspirin for recurrent stroke decreased as non-HDL-C levels increased. No significant differences in the treatment assignments across the non-HDL-C groups were observed in terms of the rate of severe or moderate bleeding (5 [0.3%] vs. 8 [0.5%] in the low non-HDL-C group; 4 [0.3%] vs. 2 [0.1%] in the high non-HDL-C group; P for interaction=0.425). Conclusion CHANCE-2 participants with low non-HDL-C levels received more clinical benefit from ticagrelor-aspirin versus clopidogrel-aspirin compared to those with high non-HDL-C, following minor ischemic stroke or transient ischemic attack.
#CHANCE-2 #Stroke #Ticagrelor #Clopidogrel #Non–high-density lipoprotein cholesterol

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