{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T01:44:32Z","timestamp":1776303872167,"version":"3.50.1"},"reference-count":35,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2025,1,21]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Elevated low\u2010density lipoprotein cholesterol is a risk factor for atherosclerotic cardiovascular disease, including acute ischemic stroke (AIS), due to large\u2010 and small\u2010vessel disease. Cholesterol management guidelines recommend lipid\u2010lowering therapy (LLT) to prevent atherosclerotic cardiovascular disease events. This study assessed use of LLT at the time of AIS according to guideline recommendations and determined the association of prestroke LLT use with stroke severity.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We conducted a retrospective study of patients hospitalized with AIS from 2015 to 2020 at a large academic comprehensive stroke center. Patients with AIS secondary to either small\u2010vessel disease or large\u2010artery atherosclerosis recorded in the institutional Get With The Guidelines\u2010Stroke registry and with a prestroke indication for LLT were included. Using propensity score subclassification, adjusted logistic regression models were built to explore the associations between LLT use before AIS when indicated and presenting National Institutes of Health Stroke Scale score &gt;4. There were 384 patients with AIS who met guideline\u2010recommended criteria for prestroke LLT (median age 70\u2009years, 57% men), of whom only 207 patients (54%) were prescribed LLT before AIS. Not being prescribed LLT when indicated was associated with a significantly higher likelihood of a presenting with National Institutes of Health Stroke Scale score &gt;4, even when adjusted for specific stroke cause (odds ratio, 1.13 [95% CI, 1.03\u20131.20];\n              <jats:italic>P<\/jats:italic>\n              =0.006).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">LLT is underused in patients who present with atherosclerosis\u2010related AIS. Lack of prestroke LLT use was associated with more severe stroke symptoms upon presentation. These findings emphasize the need to prescribe LLT when indicated, because its use may mitigate poststroke disability.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.123.033365","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T12:50:28Z","timestamp":1734612628000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Lipid\u2010Lowering Therapy Use When Indicated and Subsequent Ischemic Stroke Severity"],"prefix":"10.1161","volume":"14","author":[{"given":"Barbara","family":"Gordon\u2010Kundu","sequence":"first","affiliation":[{"name":"Department of Neurology, Division of Cerebrovascular Diseases Hackensack Meridian School of Medicine Nutley NJ USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-0854-6568","authenticated-orcid":false,"given":"Reza","family":"Peyravi","sequence":"additional","affiliation":[{"name":"Department of 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