Clinical Characteristics of First-Ever Atherothrombotic Infarction or Lacunar Infarction with Hyperlipidemia (J-STARS-C): An Analysis of Data from the Stroke Data Bank of Japan

Abstract

The clinical trial, Japan Statin Treatment Against Recurrent Stroke (J-STARS), is being carried out to investigate the efficacy of statin treatment against recurrent stroke. To participate in J-STARS, patients must have a past history of ischemic stroke excluding cardioembolic events, and must be clinically diagnosed with hyperlipidemia (HL). Before starting J-STARS, we needed to be aware of the clinical characteristics of the patients who were eligible to participate in this study. Between 1999 and 2002, 7,149 patients with ischemic stroke were enrolled in a stroke data bank developed by the Japan Standard Stroke Registry Study Group. From this, we acquired the data on 1,487 patients with first-ever atherothrombotic infarction (ATI) or lacunar infarction (LI) with a satisfactory functional outcome on discharge. Patients with HL were significantly younger (65.3+/-11.0 vs 68.4+/-10.9, p<0.0001) and showed a higher frequency of concomitant hypertension (70.9% vs 61.0%, p=0.0002), diabetes mellitus (42.2% vs 25.7%, p<0.0001) or both (31.7% vs 16.4%, p<0.0001) compared to those without HL. The ratio of ATI to LI and the frequency of prior ischemic heart disease (IHD) did not differ between the 2 groups. Among 467 patients with HL, 52.7% did not receive treatment on admission. ATI or LI patients with HL had an earlier age of onset and higher frequency of other lifestyle-related diseases, and this probably includes many with metabolic syndrome, whereas the frequency of IHD was not different between these 2 groups.