{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T17:55:38Z","timestamp":1780509338941,"version":"3.54.1"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec>\n            <jats:title>Background and Purpose\u2014<\/jats:title>\n            <jats:p>To define desirable target low-density lipoprotein (LDL) cholesterol levels for the prevention of stroke recurrence, a post hoc analysis was performed in the J-STARS study (Japan Statin Treatment Against Recurrent Stroke).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods\u2014<\/jats:title>\n            <jats:p>Subjects (n=1578) were divided into groups based on mean value of postrandomized LDL cholesterol levels until the last observation in 20 mg\/dL increments. Adjusted hazard ratios (HRs) and 95% confidence intervals were analyzed for each group, with adjustments for baseline LDL cholesterol, baseline body mass index, hypertension, diabetes mellitus, and statin usage.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results\u2014<\/jats:title>\n            <jats:p>\n              The postrandomized LDL cholesterol level until the last observation were 104.1\u00b119.3 mg\/dL in the pravastatin group and 126.1\u00b120.6 mg\/dL in the control group. The adjusted HRs for stroke and transient ischemic attack and all vascular events decreased in the postrandomized LDL cholesterol level of 80 to 100 mg\/dL (\n              <jats:italic>P<\/jats:italic>\n              =0.23 and 0.25 for the trend, respectively). The adjusted HR for atherothrombotic infarction significantly reduced with the usage of statin after adjusting baseline LDL cholesterol levels (HR, 0.39; 95% confidence intervals, 0.19\u20130.83). The adjusted HR for atherothrombotic infarction and intracranial hemorrhage were similar among the postrandomized LDL-cholesterol\u2013level subgroups (\n              <jats:italic>P<\/jats:italic>\n              =0.50 and 0.37 for the trend, respectively). The adjusted HR for lacunar infarction decreased in the postrandomized LDL cholesterol level of 100 to 120 mg\/dL (HR, 0.45; 95% confidence intervals, 0.20\u20130.99;\n              <jats:italic>P<\/jats:italic>\n              =0.41 for the trend).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>The composite risk of stroke and transient ischemic attack reduced in the postrandomized LDL cholesterol level of 80 to 100 mg\/dL after adjusting for statin usage.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Clinical Trial Registration\u2014<\/jats:title>\n            <jats:p>\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT00221104.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.117.018870","type":"journal-article","created":{"date-parts":[[2018,3,6]],"date-time":"2018-03-06T10:08:43Z","timestamp":1520330923000},"page":"865-871","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Desirable Low-Density Lipoprotein Cholesterol Levels for Preventing Stroke Recurrence"],"prefix":"10.1161","volume":"49","author":[{"given":"Naohisa","family":"Hosomi","sequence":"first","affiliation":[{"name":"From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women\u2019s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Kitagawa","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women\u2019s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoji","family":"Nagai","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women\u2019s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoko","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women\u2019s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiro","family":"Aoki","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women\u2019s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohisa","family":"Nezu","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women\u2019s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuo","family":"Kagimura","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women\u2019s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirofumi","family":"Maruyama","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women\u2019s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideki","family":"Origasa","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women\u2019s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuo","family":"Minematsu","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women\u2019s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichiro","family":"Uchiyama","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women\u2019s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. Nakagawa, T.K.);..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayasu","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"From the Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan (N.H., S.A., T.N., H.M., M.M.); Department of Neurology, Tokyo Women\u2019s Medical University School of Medicine, Japan (K.K.); Center for Clinical Research, Kobe University Hospital, Japan (Y. Nagai); Division of Medical Statistics, Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan (Y. 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