J Korean Neurol Assoc.  2022 Aug;40(3):217-227. 10.17340/jkna.2022.3.1.

Management of Dyslipidemia after Stroke

Affiliations
  • 1Department of Neurology, Ewha Womans University Mokdong Hospital, College of Medicine, Ewha Womans University, Seoul, Korea
  • 2Department of Neurology, Ewha Womans University Seoul Hospital, College of Medicine, Ewha Womans University, Seoul, Korea

Abstract

Dyslipidemia is a major risk factor for stroke, following hypertension, diabetes, and smoking. Treatment of dyslipidemia is important for the prevention and treatment of various vascular diseases, including stroke, coronary artery disease, and peripheral vascular disease. Statins, ezetimibe, and proprotein convertase subtilisinkexin type 9 (PCSK9) inhibitors have been shown to reduce the risk of stroke and cardiovascular disease in previous studies. When prescribing dyslipidemia drugs for secondary prevention of stroke, the combination, type, and dose of dyslipidemia drugs should be appropriately selected according to the patient's comorbidity and stroke subtype. In the case of statins, highintensity statin administration should be considered, but it is essential to take into account side effects, comorbidities, and individual characteristics of each patient. If the target low density lipoproteincholesterol level is not reached or inappropriate drug dosing due to the side effects of statins, ezetimibe or a PCSK9 inhibitor may be considered. Finally, statin discontinuation due to improper judgment may be detrimental to the patient in the longterm view.

Keyword

Stroke; Dyslipidemias; HydroxymethylglutarylCoA reductase inhibitors; Ezetimibe; PCSK9 inhibitor
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