The machine learning methods aid to choose ezetimibe or statins for ischemic stroke patients with SLCO1B1 variants

Statins had a higher risk of statin-induced side effects for acute ischemic stroke patients with SLCO1B1 variants. Ezetimibe might reach the low-density lipoprotein cholesterol (LDL-C) level to recommend a range with a low risk of side effects. Which effect was better needs validation?

Data from acute ischemic stroke patients with SLCO1B1 variants administered. The stroke recurrence within 1 year and recommended LDL-C level 30 days after admission were used to evaluate the primary outcome. The secondary outcome included unfavorable functional outcomes and side effects of statins.

The mean age of the 158 patients was 66.59 ± 13.268 years, and 65 were female (41.1%). The ezetimibe group had a lower stroke recurrence (6.3% vs. 17.9%, p = 0.036), a higher rate of patients reaching the recommended LDL-C level (81.0% vs. 48.4%, p < 0.001), and a lower rate of side effects of statins (3.2% vs. 13.7%, p = 0.027). Regression analysis showed the ezetimibe was related to stroke recurrence (OR = 0.276, p = 0.039), the recommended LDL-C level (OR = 2.312, p < 0.001), and side effects of statins (OR = 0.194, p = 0.038), but not to unfavorable functional outcomes at 90 days after admission (OR = 0.960, p = 0.911). The patients had a significant difference in base character and outcome events between the hierarchical clustering groups.

The ezetimibe group had a lower rate of recurrence and side effects, a higher rate of recommended LDL-C level, and a similar unfavorable functional outcome. For male, younger stroke patients with SLCO1B1 variants, higher blood pressure, and blood lipid using ezetimibe are related to a better prognosis than other patients.