Reduction in the Recurrence of Stroke by Eicosapentaenoic Acid for Hypercholesterolemic Patients: Subanalysis of the JELIS Trial
Abstract
Background and Purpose— The JELIS trial examined the preventive effect of eicosapentaenoic acid (EPA) against coronary artery diseases. Hypercholesterolemic patients received statin only (no EPA group: n=9319) or statin with EPA (EPA group: n=9326) for around 5 years. EPA significantly suppressed the incidence of coronary events in previous analysis. Herein, we investigated the effects of EPA on the primary and secondary prevention of stroke. Methods— We conducted a subanalysis of JELIS with respect to stroke incidence in the primary and secondary prevention subgroups defined as those without and with a prior history of stroke using Cox proportional hazard ratios, adjusted for baseline risk factor levels. Results— As for primary prevention of stroke, this occurred in 114 (1.3%) of 8862 no EPA group and in 133 (1.5%) of 8841 EPA group. No statistically significant difference in total stroke incidence (Hazard Ratio, 1.08; 95% confidence interval, 0.95 to 1.22) was observed between the no EPA and the EPA groups. In the secondary prevention subgroup, stroke occurred in 48 (10.5%) of 457 no EPA group and in 33 (6.8%) of 485 EPA group, showing a 20% relative reduction in recurrent stroke in the EPA group (Hazard Ratio, 0.80; 95% confidence interval, 0.64 to 0.997). Conclusions— Administration of highly purified EPA appeared to reduce the risk of recurrent stroke in a Japanese population of hypercholesterolemic patients receiving low-dose statin therapy. Further research is needed to determine whether similar benefits are found in other populations with lower levels of fish intake. The trial is registered at ClinicalTrials.gov (number NCT00231738).
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The effectiveness of statins for preventing the first occurrence and recurrence of stroke in Japanese populations was confirmed in a sub-analysis of the MEGA study and in the JELIS study.
“The effectiveness of statins for preventing the first occurrence and recurrence of stroke in Japanese populations was confirmed in a sub-analysis of the MEGA study620, 621) and in the JELIS study622).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [620]
The MEGA study showed that statin administration tends to decrease stroke incidence, with hazard ratios of 0.66 (men) and 0.63 (women).
“Among the other studies conducted in Japan, the MEGA study, which involved subjects with no history of CAD or stroke, showed that statin administration tends to decrease stroke incidence, with hazard ratios of 0.66 (men) and 0.63 (women)620).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [620]
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- Authors
- Tanaka, K., Ishikawa, Y., Yokoyama, M., Origasa, H., Matsuzaki, M., Saito, Y., Matsuzawa, Y., Sasaki, J., Oikawa, S., Hishida, H., Itakura, H., Kita, T., Kitabatake, A., Nakaya, N., Sakata, T., Shimada, K., & Shirato, K.
- Affiliations
- Toyama University Hospital (JP)
- From the Department of Neurology (K.T.), Toyama University Hospital, Toyama, Japan; Faculty of Health Sciences (Y.I.), Kobe University School of Medicine, Kobe, Japan; Division of Cardiovascular and Respiratory Medicine, Department of Internal Medicine (M.Y.), Kobe University Graduate School of Medicine, Kobe, Japan; Division of Biostatistics and Clinical Epidemiology (H.O.), University of Toyama, Toyama, Japan; Division of Cardiology, Department of Medicine and Clinical Science (M.M.), Yamaguchi...
- Venue
- Stroke
- Published
- 2008-07
- Volume
- 39
- Issue
- 7
- Pages
- 2052-2058
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- OpenAlex
- W2114344280
- Cited by
- 217
- References
- 39
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 5 · 2023: 8 · 2022: 16 · 2021: 12 · 2020: 17 · 2019: 14 · 2018: 16 · 2017: 13 · 2016: 12 · 2015: 11 · 2014: 15 · 2013: 12 · 2012: 22
- FWCI
- 12.46
- Type
- journal article
- Language
- en
- Update notices
- correction (2008-09-01)
- Open access
- closed
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Mochida Pharmaceutical Company
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Fatty Acid Research and Health
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Keywords
- eicosapentaenoic acid, stroke recurrence, secondary stroke prevention, primary stroke prevention, hypercholesterolemia, statin therapy, omega-3 fatty acids, fish oil supplementation
- MeSH terms
- Adult, Aged, Anticholesteremic Agents, Fatty Acids, Female, Humans, Hypercholesterolemia, Male, Middle Aged, Prospective Studies, Recurrence, Eicosapentaenoic Acid, Proportional Hazards Models, Stroke
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