Incidental Statin Use and the Risk of Stroke or Transient Ischemic Attack after Radiotherapy for Head and Neck Cancer / 대한뇌졸중학회지
Journal of Stroke
; : 71-79, 2018.
Article
em En
| WPRIM
| ID: wpr-740608
Biblioteca responsável:
WPRO
ABSTRACT
BACKGROUND AND PURPOSE:
Interventions to reduce the risk for cerebrovascular events (CVE; stroke and transient ischemic attack [TIA]) after radiotherapy (RT) for head and neck cancer (HNCA) are needed. Among broad populations, statins reduce CVEs; however, whether statins reduce CVEs after RT for HNCA is unclear. Therefore, we aimed to test whether incidental statin use at the time of RT is associated with a lower rate of CVEs after RT for HNCA.METHODS:
From an institutional database we identified all consecutive subjects treated with neck RT from 2002 to 2012 for HNCA. Data collection and event adjudication was performed by blinded teams. The primary outcome was a composite of ischemic stroke and TIA. The secondary outcome was ischemic stroke. The association between statin use and events was determined using Cox proportional hazard models after adjustment for traditional and RT-specific risk factors.RESULTS:
The final cohort consisted of 1,011 patients (59±13 years, 30% female, 44% hypertension) with 288 (28%) on statins. Over a median follow-up of 3.4 years (interquartile range, 0.1 to 14) there were 102 CVEs (89 ischemic strokes and 13 TIAs) with 17 in statin users versus 85 in nonstatins users. In a multivariable model containing known predictors of CVE, statins were associated with a reduction in the combination of stroke and TIA (hazard ratio [HR], 0.4; 95% confidence interval [CI], 0.2 to 0.8; P=0.01) and ischemic stroke alone (HR, 0.4; 95% CI, 0.2 to 0.8; P=0.01).CONCLUSIONS:
Incidental statin use at the time of RT for HNCA is associated with a lower risk of stroke or TIA.Palavras-chave
Texto completo:
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Índice:
WPRIM
Assunto principal:
Radioterapia
/
Modelos de Riscos Proporcionais
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Ataque Isquêmico Transitório
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Coleta de Dados
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Fatores de Risco
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Estudos de Coortes
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Seguimentos
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Inibidores de Hidroximetilglutaril-CoA Redutases
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Acidente Vascular Cerebral
/
Cabeça
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
Idioma:
En
Revista:
Journal of Stroke
Ano de publicação:
2018
Tipo de documento:
Article