Ezetimibe in the prevention of ischemic stroke / 国际脑血管病杂志

ABSTRACT

Dyslipidemia is a risk factor for stroke, and reducing low-density lipoprotein cholesterol (LDL-C) levels can decrease the risk of ischemic stroke. Both statins and PCSK9 inhibitors can effectively reduce LDL-C levels, but some patients cannot tolerate statins, and PCSK9 inhibitors are expensive. Animal experiments have shown that ezetimibe can reduce oxidative stress and endoplasmic reticulum stress response, inhibit cell apoptosis, increase autophagy, and protect nerve tissue by activating AMP activated protein kinase (AMPK) signaling pathway. Clinical studies have shown that ezetimibe can further reduce LDL-C levels on the basis of statin therapy, and reduce the risk of ischemic stroke in patients with acute coronary syndromes, and there is no obvious adverse reaction. However, ezetimibe cannot reduce the incidence of stroke in elderly people who are ≥75 years old, have elevated LDL-C and do not have coronary heart disease. At present, there are few studies on the use of ezetimibe for secondary prevention of ischemic stroke, and its effect needs to be further confirmed by large randomized controlled trials.