{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,7]],"date-time":"2026-03-07T14:50:35Z","timestamp":1772895035783,"version":"3.50.1"},"reference-count":13,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"11","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Stroke"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>In atherosclerotic stroke, lipid-lowering treatment with a target LDL (low-density lipoprotein) cholesterol of &lt;70 compared with 100\u00b110 mg\/dL reduced the risk of subsequent cardiovascular events. This post hoc analysis explored the relative effects of the combination of statin and ezetimibe (dual therapy) and statin monotherapy in achieving the lower LDL cholesterol target and in reducing the risk of major vascular events, as compared with the higher target group.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>Patients with ischemic stroke in the previous 3 months or transient ischemic attack within the previous 15 days and evidence of cerebrovascular or coronary artery atherosclerosis were randomly assigned to a target LDL cholesterol of &lt;70 or 100\u00b110 mg\/dL, using statin and\/or ezetimibe as needed. The primary outcome was the composite of ischemic stroke, myocardial infarction, new symptoms requiring urgent coronary or carotid revascularization, and vascular death. Cox regression model including lipid-lowering therapy as a time varying variable, after adjustment for randomization strategy, age, sex, index event (stroke or transient ischemic attack), and time since the index event.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Among 2860 patients enrolled, patients who were on dual therapy during the trial in the lower target group had a higher baseline LDL cholesterol as compared to patients on statin monotherapy (141\u00b138 versus 131\u00b136, respectively,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). In patients on dual therapy and on statin monotherapy, the achieved LDL cholesterol was 66.2 and 64.1 mg\/dL respectively, and the primary outcome was reduced during dual therapy as compared with the higher target group (HR, 0.60 [95% CI, 0.39\u20130.91];\n              <jats:italic>P<\/jats:italic>\n              =0.016) but not during statin monotherapy (HR, 0.92 [95% CI, 0.70\u20131.20];\n              <jats:italic>P<\/jats:italic>\n              =0.52), with no significant increase in intracranial bleeding.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>In the TST trial (Treat Stroke to Target), targeting an LDL cholesterol of &lt; 70 mg\/dL with a combination of statin and ezetimibe compared with 100\u00b110 mg\/dL consistently reduced the risk of subsequent stroke.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Registration:<\/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=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT01252875. URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrialsregister.eu\">clinicaltrialsregister.eu<\/jats:ext-link>\n              ; Unique identifier: EUDRACT2009-A01280-57.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/strokeaha.122.039728","type":"journal-article","created":{"date-parts":[[2022,9,26]],"date-time":"2022-09-26T13:30:27Z","timestamp":1664199027000},"page":"3260-3267","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":21,"title":["Yield of Dual Therapy With Statin and Ezetimibe in the Treat Stroke to Target Trial"],"prefix":"10.1161","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3842-1236","authenticated-orcid":true,"given":"Pierre","family":"Amarenco","sequence":"first","affiliation":[{"name":"APHP, Department of Neurology and Stroke center, Bichat Hospital, INSERM LVTS-U1148, DHU FIRE, University of Paris, France (P.A., H.C., P.C.L., E.M.)."},{"name":"Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada (P.A.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jong S.","family":"Kim","sequence":"additional","affiliation":[{"name":"Asan Medical Center, Seoul, South Korea (J.S.K.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3384-0423","authenticated-orcid":true,"given":"Julien","family":"Labreuche","sequence":"additional","affiliation":[{"name":"CHU Lille, Department of Biostatistics, France (J.L.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugo","family":"Charles","sequence":"additional","affiliation":[{"name":"APHP, Department of Neurology and Stroke center, Bichat Hospital, INSERM LVTS-U1148, DHU FIRE, University of Paris, France (P.A., H.C., P.C.L., E.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0718-8523","authenticated-orcid":true,"given":"Maurice","family":"Giroud","sequence":"additional","affiliation":[{"name":"Department of Neurology, University Hospital of Dijon, Dijon Stroke Registry, EA 7460, University of Burgundy, UBFC, France (M.G.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3885-981X","authenticated-orcid":true,"given":"Byung-Chul","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea (B.-C.L.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8148-7679","authenticated-orcid":true,"given":"Philippa C.","family":"Lavall\u00e9e","sequence":"additional","affiliation":[{"name":"APHP, Department of Neurology and Stroke center, Bichat Hospital, INSERM LVTS-U1148, DHU FIRE, University of Paris, France (P.A., H.C., P.C.L., E.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie-H\u00e9l\u00e8ne","family":"Mahagne","sequence":"additional","affiliation":[{"name":"Stroke Unit, Pasteur Hospital, Nice, France (M.-H.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7184-2614","authenticated-orcid":true,"given":"Elena","family":"Meseguer","sequence":"additional","affiliation":[{"name":"APHP, Department of Neurology and Stroke center, Bichat Hospital, INSERM LVTS-U1148, DHU FIRE, University of Paris, France (P.A., H.C., P.C.L., E.M.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0594-4409","authenticated-orcid":true,"given":"Norbert","family":"Nighoghossian","sequence":"additional","affiliation":[{"name":"Hospices Civils de Lyon, Department of Neurology and Stroke Center, Lyon University, France (N.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6896-2941","authenticated-orcid":true,"given":"Philippe Gabriel","family":"Steg","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, INSERM LVTS-U1148, France (P.G.S.)."},{"name":"AP-HP, H\u00f4pital Bichat, France (P.G.S.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c9ric","family":"Vicaut","sequence":"additional","affiliation":[{"name":"APHP, Department of Biostatistics, Universit\u00e9 Paris-Diderot, Sorbonne-Paris Cit\u00e9, Fernand Widal hospital, Paris, France (\u00c9.V.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Bruckert","sequence":"additional","affiliation":[{"name":"APHP, Department of Endocrinology, Piti\u00e9-Salp\u00eatri\u00e8re hospital, Sorbonne University, Paris, France (E.B.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"on behalf of the Treat Stroke to Target Investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/STR.0000000000000375"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa061894"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.516450"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1910355"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.117.030950"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/2396987319838100"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.192218"},{"key":"e_1_3_3_9_2","first-page":"1788","article-title":"AFSSAPS guidelines for the treatment of dyslipidemia.","volume":"55","author":"Agence Fran\u00e7aise de S\u00e9curit\u00e9 Sanitaire des Produits de Sant\u00e9 (AFSSAPS)","year":"2005","unstructured":"Agence Fran\u00e7aise de S\u00e9curit\u00e9 Sanitaire des Produits de Sant\u00e9 (AFSSAPS). AFSSAPS guidelines for the treatment of dyslipidemia. Rev Prat. 2005;55:1788\u20131793","journal-title":"Rev Prat"},{"key":"e_1_3_3_10_2","first-page":"231","volume-title":"Clinical Practice Guidelines for Stroke","year":"2013","unstructured":"Secondary prevention of stroke. In Clinical Practice Guidelines for Stroke. Clinical Research Center for Stroke; 2013:231\u2013248. http:\/\/www.stroke.or.kr\/eng\/\/image\/main\/CPGStrok(English)20130730.pdf"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0038-1651587"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(09)70058-4"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)61350-5"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31357-5"}],"container-title":["Stroke"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/STROKEAHA.122.039728","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,24]],"date-time":"2022-10-24T18:01:50Z","timestamp":1666634510000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/STROKEAHA.122.039728"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11]]},"references-count":13,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1161\/STROKEAHA.122.039728"],"URL":"https:\/\/doi.org\/10.1161\/strokeaha.122.039728","relation":{},"ISSN":["0039-2499","1524-4628"],"issn-type":[{"value":"0039-2499","type":"print"},{"value":"1524-4628","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11]]},"assertion":[{"value":"2022-04-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-05","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-09-26","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}