Abstract
BACKGROUND: 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? METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.