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Association Between Endothelial Cell Stabilizing Medication and Small Vessel Disease Stroke: A Case-Control Study.
Charlotte Elisabeth Becker1,2, Terence J Quinn3, Anna Williams1
1Centre for Regenerative Medicine, UK Dementia Research Institute, University of Edinburgh, Edinburgh, United Kingdom.
Frontiers in Neurology
|October 15, 2019
Summary
Endothelial cell (EC) dysfunction is linked to cerebral small vessel disease. Prior use of EC-stabilizing medications, including antihypertensives and statins, was associated with a reduced risk of lacunar stroke.
Area of Science:
- Neurology
- Cardiovascular Research
- Pharmacology
Background:
- Endothelial cell (EC) dysfunction is increasingly implicated in the development of cerebral small vessel disease (CSVD).
- Commonly prescribed medications such as antihypertensives and statins possess EC-stabilizing properties.
- Lacunar stroke serves as a clinical indicator for CSVD, making it a valuable endpoint for studying disease mechanisms.
Purpose of the Study:
- To investigate the association between prior exposure to EC-stabilizing medications and the incidence of lacunar stroke.
- To determine if EC-stabilizing medications confer a protective effect against CSVD, using lacunar stroke as a proxy.
- To identify potential confounding factors and refine the analysis of EC-stabilizing medication effects.
Main Methods:
- Individual patient data from completed acute stroke trials were analyzed.
- A cohort of 12,002 patients with available data was assessed.
- Logistic regression models were employed to evaluate the association between EC-stabilizing medication exposure and lacunar stroke, with adjustments for potential confounders.
Main Results:
- Among 12,002 patients, 2,855 (24%) experienced a lacunar stroke.
- Initial analyses showed conflicting results regarding the independent association of EC-stabilizing medication exposure and lacunar stroke.
- When statins were included in the EC-stabilizing category, a significant beneficial effect was observed (O.R. 0.83, 95% C.I.: 0.73-0.93), suggesting reduced lacunar stroke incidence.
Conclusions:
- Exposure to EC-stabilizing medications, encompassing antihypertensives and statins, is associated with a reduced incidence of lacunar stroke.
- These findings support the potential role of EC-stabilizing therapies in preventing CSVD.
- Future research and clinical trial analyses should account for the endothelial effects of co-prescribed medications when evaluating EC-stabilizing interventions.
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