Skip to main content

Advertisement

SpringerLink
Log in

Lipid-Modifying Therapies and Stroke Prevention

  • Stroke (B. Ovbiagele, Section Editor)
  • Published:
Current Neurology and Neuroscience Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

We reviewed lipid-modifying therapies and the risk of stroke and other cerebrovascular outcomes, with a focus on newer therapies.

Recent Findings

Statins and ezetimibe reduce ischemic stroke risk without increasing hemorrhagic stroke risk. Proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors similarly reduce ischemic stroke risk in statin-treated patients with atherosclerosis without increasing hemorrhagic stroke, even with very low achieved low-density lipoprotein cholesterol levels. Icosapent ethyl reduces the risk of total and first ischemic stroke in patients with established cardiovascular disease or diabetes mellitus. Clinical outcome trials are underway for newer lipid-modifying agents, including inclisiran, bempedoic acid, and pemafibrate. New biologic agents including evinacumab, pelacarsen, olpasiran, and SLN360 are also discussed.

Summary

In addition to statins and ezetimibe, PCSK9 inhibitors and icosapent ethyl reduce the risk of ischemic stroke without increasing the risk of hemorrhagic stroke. These therapies dramatically expand options for reducing stroke in high-risk settings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Saini V, Guada L, Yavagal DR. Global epidemiology of stroke and access to acute ischemic stroke interventions. Neurology. 2021;97(20 Suppl 2):S6–S16.

    Article  PubMed  Google Scholar 

  2. Diener HC, Hankey GJ. Primary and secondary prevention of ischemic stroke and cerebral hemorrhage: JACC Focus Seminar. J Am Coll Cardiol. 2020;75:1804–18.

    Article  PubMed  Google Scholar 

  3. Getz GS, Reardon CA. Atherosclerosis: cell biology and lipoproteins. Curr Opin Lipidol. 2020;31:286–90.

    Article  CAS  PubMed  Google Scholar 

  4. Berberich AJ, Hegele RA. A modern approach to dyslipidemia. Endocr Rev. 2021 Oct 22:bnab037. https://doi.org/10.1210/endrev/bnab037. Online ahead of print.

  5. Hackam DG, Hegele RA. Cholesterol lowering and prevention of stroke. Stroke. 2019;50:537–41.

    Article  PubMed  Google Scholar 

  6. Aradine E, Hou Y, Cronin CA, Chaturvedi S. Current status of dyslipidemia treatment for stroke prevention. Curr Neurol Neurosci Rep. 2020;20:31.

    Article  PubMed  Google Scholar 

  7. Milionis H, Ntaios G, Korompoki E, Vemmos K, Michel P. Statin-based therapy for primary and secondary prevention of ischemic stroke: a meta-analysis and critical overview. Int J Stroke. 2020;15:377–84.

    Article  PubMed  Google Scholar 

  8. Cholesterol Treatment Trialists’ (CTT) Collaboration, Baigent C, Blackwell L, Emberson J, Holland LE, Reith C, Bhala N, Peto R, Barnes EH, Keech A, Simes J, Collins R. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomised trials. Lancet. 2010; 376:1670-81.

  9. Zhan S, Tang M, Liu F, Xia P, Shu M, Wu X. Ezetimibe for the prevention of cardiovascular disease and all-cause mortality events. Cochrane Database Syst Rev. 2018;11:CD012502.

    PubMed  Google Scholar 

  10. Qin J, Liu L, Su XD, Wang BB, Fu BS, Cui JZ, Liu XY. The effect of PCSK9 inhibitors on brain stroke prevention: a systematic review and meta-analysis. Nutr Metab Cardiovasc Dis. 2021;31:2234–43.

    Article  CAS  PubMed  Google Scholar 

  11. • Bhatt DL, Steg PG, Miller M, Brinton EA, Jacobson TA, Ketchum SB, Doyle RT Jr, Juliano RA, Jiao L, Granowitz C, Tardif JC, Ballantyne CM, Investigators R-I. Cardiovascular risk reduction with icosapent ethyl for hypertriglyceridemia. N Engl J Med. 2019;380:11–22 A large randomized trial showing benefit with icosapent ethyl on an array of cardiovascular endpoints, including stroke, in patients at elevated cardiovascular risk and hypertriglyceridemia.

    Article  CAS  PubMed  Google Scholar 

  12. Khan MS, Krasuski RA. The LDL cholesterol in stroke limbo: how low can we go? Curr Opin Lipidol. 2020;31:161–2.

    Article  CAS  PubMed  Google Scholar 

  13. • Masson W, Lobo M, Siniawski D, Masson G, Lavalle-Cobo A, Molinero G. LDL-C levels below 55 mg/dl and risk of hemorrhagic stroke: a meta-analysis. J Stroke Cerebrovasc Dis. 2021;30:105655 Achievement of LDL-C levels below 55 mg/dL is not associated with the occurrence of hemorrhagic stroke.

    Article  PubMed  Google Scholar 

  14. Feingold KR. Maximizing the benefits of cholesterol-lowering drugs. Curr Opin Lipidol. 2019;30:388–94.

    Article  CAS  PubMed  Google Scholar 

  15. Cannon CP, Blazing MA, Giugliano RP, McCagg A, White JA, Theroux P, Darius H, Lewis BS, Ophuis TO, Jukema JW, De Ferrari GM, Ruzyllo W, De Lucca P, Im K, Bohula EA, Reist C, Wiviott SD, Tershakovec AM, Musliner TA, et al. Ezetimibe added to statin therapy after acute coronary syndromes. N Engl J Med. 2015;372:2387–97.

    Article  CAS  PubMed  Google Scholar 

  16. Oyama K, Giugliano RP, Blazing MA, Park JG, Tershakovec AM, Sabatine MS, Cannon CP, Braunwald E. Baseline low-density lipoprotein cholesterol and clinical outcomes of combining ezetimibe with statin therapy in IMPROVE-IT. J Am Coll Cardiol. 2021;78:1499–507.

    Article  CAS  PubMed  Google Scholar 

  17. De Caterina R, Salvatore T, Marchioli R. All cholesterol-lowering interventions are expected to reduce stroke: confirmatory data from IMPROVE-IT. Data Brief. 2016;7:1541–50.

    Article  PubMed  PubMed Central  Google Scholar 

  18. •• Amarenco P, Kim JS, Labreuche J, Charles H, Abtan J, Béjot Y, Cabrejo L, Cha JK, Ducrocq G, Giroud M, Guidoux C, Hobeanu C, Kim YJ, Lapergue B, Lavallée PC, Lee BC, Lee KB, Leys D, Mahagne MH, et al. A comparison of two LDL cholesterol targets after ischemic stroke. N Engl J Med. 2020;382:9 A large randomized trial showing the superiority of a lower LDL-C target for preventing cardiovascular events in patients with atherosclerotic ischemic stroke.

    Article  CAS  PubMed  Google Scholar 

  19. Amarenco P, Kim JS, Labreuche J, Charles H, Giroud M, Lee BC, Mahagne MH, Nighoghossian N, Gabriel Steg P, Vicaut É, Bruckert E. Treat Stroke to Target Investigators. Benefit of targeting a LDL cholesterol <70 mg/dL during 5 years after ischemic stroke. Stroke. 2020;51:1231–9.

    Article  CAS  PubMed  Google Scholar 

  20. Rosenson RS, Hegele RA, Fazio S, Cannon CP. The evolving future of PCSK9 inhibitors. J Am Coll Cardiol. 2018;72:314–29.

    Article  CAS  PubMed  Google Scholar 

  21. Hegele RA, Tsimikas S. Lipid-lowering agents. Circ Res. 2019;124:386–404.

    Article  CAS  PubMed  Google Scholar 

  22. Sabatine MS, Giugliano RP, Keech AC, Honarpour N, Wiviott SD, Murphy SA, Kuder JF, Wang H, Liu T, Wasserman SM, Sever PS, Pedersen TR. FOURIER Steering Committee and Investigators. Evolocumab and clinical outcomes in patients with cardiovascular disease. N Engl J Med. 2017;376:1713–22.

    Article  CAS  PubMed  Google Scholar 

  23. •• Giugliano RP, Pedersen TR, Saver JL, Sever PS, Keech AC, Bohula EA, Murphy SA, Wasserman SM, Honarpour N, Wang H, Lira Pineda A, Sabatine MS. FOURIER Investigators. Stroke prevention with the PCSK9 (proprotein convertase subtilisin-kexin type 9) inhibitor evolocumab added to statin in high-risk patients with stable atherosclerosis. Stroke. 2020;51:1546–54 A comprehensive analysis of the effects of evolocumab on stroke risk in patients with atherosclerotic cardiovascular disease.

    Article  CAS  PubMed  Google Scholar 

  24. Oyama K, Giugliano RP, Tang M, Bonaca MP, Saver JL, Murphy SA, Ruzza A, Keech AC, Sever PS, Sabatine MS, Bergmark BA. Effect of evolocumab on acute arterial events across all vascular territories : results from the FOURIER trial. Eur Heart J. 2021;42:4821–9.

    Article  CAS  PubMed  Google Scholar 

  25. Schwartz GG, Steg PG, Szarek M, Bhatt DL, Bittner VA, Diaz R, Edelberg JM, Goodman SG, Hanotin C, Harrington RA, Jukema JW, Lecorps G, Mahaffey KW, Moryusef A, Pordy R, Quintero K, Roe MT, Sasiela WJ, Tamby JF, et al. ODYSSEY OUTCOMES Committees and Investigators. Alirocumab and cardiovascular outcomes after acute coronary syndrome. N Engl J Med. 2018;379:2097–107.

    Article  CAS  PubMed  Google Scholar 

  26. •• Jukema JW, Zijlstra LE, Bhatt DL, Bittner VA, Diaz R, Drexel H, Goodman SG, Kim YU, Pordy R, Reiner Ž, Roe MT, Tse HF, Montenegro Valdovinos PC, White HD, Zeiher AM, Szarek M, Schwartz GG, Steg PG, ODYSSEY OUTCOMES Investigators. Effect of alirocumab on stroke in ODYSSEY OUTCOMES. Circulation. 2019;140:2054–62 A comprehensive analysis of the effects of alirocumab on stroke risk in patients presenting with acute coronary syndrome.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Lewis GF, Hegele RA. Effective, disease-modifying, clinical approaches to patients with mild-to-moderate hypertriglyceridaemia. Lancet Diabetes Endocrinol. 2022;10:142–8.

    Article  CAS  PubMed  Google Scholar 

  28. Sniderman A, Langlois M, Cobbaert C. Update on apolipoprotein B. Curr Opin Lipidol. 2021;32:226–30.

    Article  CAS  PubMed  Google Scholar 

  29. Huet F, Roubille C, Roubille F. Is hypertriglyceridemia atherogenic? Curr Opin Lipidol. 2019;30:291–9.

    Article  CAS  PubMed  Google Scholar 

  30. Ganda OP. When to lower triglycerides? Curr Opin Lipidol. 2020;31:238–45.

    Article  CAS  PubMed  Google Scholar 

  31. Laufs U, Parhofer KG, Ginsberg HN, Hegele RA. Clinical review on triglycerides. Eur Heart J. 2020;41:99–109.

    Article  CAS  PubMed  Google Scholar 

  32. Gencer B, Djousse L, Al-Ramady OT, Cook NR, Manson JE, Albert CM. Effect of long-term marine ɷ-3 fatty acids supplementation on the risk of atrial fibrillation in randomized controlled trials of cardiovascular outcomes: a systematic review and meta-analysis. Circulation. 2021;144:1981–90.

    Article  CAS  PubMed  Google Scholar 

  33. Gaba P, Bhatt DL, Giugliano RP, Steg PG, Miller M, Brinton EA, Jacobson TA, Ketchum SB, Juliano RA, Jiao L, Doyle RT Jr, Granowitz C, Tardif JC, Ballantyne CM, Pinto DS, Budoff MJ, Gibson CM. Comparative reductions in investigator-reported and adjudicated ischemic events in REDUCE-IT. J Am Coll Cardiol. 2021;78:1525–37.

    Article  CAS  PubMed  Google Scholar 

  34. Nicholls SJ, Lincoff AM, Garcia M, Bash D, Ballantyne CM, Barter PJ, Davidson MH, Kastelein JJP, Koenig W, McGuire DK, Mozaffarian D, Ridker PM, Ray KK, Katona BG, Himmelmann A, Loss LE, Rensfeldt M, Lundström T, Agrawal R, et al. Effect of high-dose omega-3 fatty acids vs corn oil on major adverse cardiovascular events in patients at high cardiovascular risk: the STRENGTH randomized clinical trial. JAMA. 2020;324:2268–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Sherratt SCR, Lero M, Mason RP. Are dietary fish oil supplements appropriate for dyslipidemia management? A review of the evidence. Curr Opin Lipidol. 2020;31:94–100.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Brandts J, Ray KK. Small interfering RNA to proprotein convertase subtilisin/kexin type 9: transforming LDL-cholesterol-lowering strategies. Curr Opin Lipidol. 2020;31:182–6.

    Article  CAS  PubMed  Google Scholar 

  37. Khan SA, Naz A, Qamar Masood M, Shah R. Meta-analysis of inclisiran for the treatment of hypercholesterolemia. Am J Cardiol. 2020;134:69–73.

    Article  CAS  PubMed  Google Scholar 

  38. Tombling BJ, Zhang Y, Huang YH, Craik DJ, Wang CK. The emerging landscape of peptide-based inhibitors of PCSK9. Atherosclerosis. 2021;330:52–60.

    Article  CAS  PubMed  Google Scholar 

  39. Salaheldin TA, Godugu K, Bharali DJ, Fujioka K, Elshourbagy N, Mousa SA. Novel oral nano-hepatic targeted anti-PCSK9 in hypercholesterolemia. Nanomedicine. 2022;40:102480.

    Article  CAS  PubMed  Google Scholar 

  40. Momtazi-Borojeni AA, Jaafari MR, Afshar M, Banach M, Sahebkar A. PCSK9 immunization using nanoliposomes: preventive efficacy against hypercholesterolemia and atherosclerosis. Arch Med Sci. 2021;17:1365–77.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Whittaker MN, Musunuru K. Therapeutic application of genome editing in dyslipidemia. Curr Opin Lipidol. 2022;33:133–8.

    Article  CAS  PubMed  Google Scholar 

  42. Burke AC, Telford DE, Huff MW. Bempedoic acid: effects on lipoprotein metabolism and atherosclerosis. Curr Opin Lipidol. 2019;30:1–9.

    Article  CAS  PubMed  Google Scholar 

  43. Ballantyne CM, Bays H, Catapano AL, Goldberg A, Ray KK, Saseen JJ. Role of bempedoic acid in clinical practice. Cardiovasc Drugs Ther. 2021;35:853–64.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Goldberg AC, Leiter LA, Stroes ESG, Baum SJ, Hanselman JC, Bloedon LT, Lalwani ND, Patel PM, Zhao X, Duell PB. Effect of bempedoic acid vs placebo added to maximally tolerated statins on low-density lipoprotein cholesterol in patients at high risk for cardiovascular disease: the CLEAR Wisdom randomized clinical trial. JAMA. 2019;322:1780–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Gaudet D, Durst R, Lepor N, Bakker-Arkema R, Bisgaier C, Masson L, Golden L, Kastelein JJ, Hegele RA, Stein E. Usefulness of gemcabene in homozygous familial hypercholesterolemia (from COBALT-1). Am J Cardiol. 2019;124:1876–80.

    Article  CAS  PubMed  Google Scholar 

  46. Ng DS. Evolving ANGPTL-based lipid-lowering strategies and beyond. Curr Opin Lipidol. 2021;32:271–2.

    Article  CAS  PubMed  Google Scholar 

  47. Kersten S. ANGPTL3 as therapeutic target. Curr Opin Lipidol. 2021;32:335–41.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Stitziel NO, Khera AV, Wang X, Bierhals AJ, Vourakis AC, Sperry AE, Natarajan P, Klarin D, Emdin CA, Zekavat SM, Nomura A, Erdmann J, Schunkert H, Samani NJ, Kraus WE, Shah SH, Yu B, Boerwinkle E, Rader DJ, et al. PROMIS and Myocardial Infarction Genetics Consortium Investigators. ANGPTL3 deficiency and protection against coronary artery disease. J Am Coll Cardiol. 2017;69:2054–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  49. Rosenson RS, Burgess LJ, Ebenbichler CF, Baum SJ, Stroes ESG, Ali S, Khilla N, Hamlin R, Pordy R, Dong Y, Son V, Gaudet D. Evinacumab in patients with refractory hypercholesterolemia. N Engl J Med. 2020;383:2307–19.

    Article  CAS  PubMed  Google Scholar 

  50. Raal FJ, Rosenson RS, Reeskamp LF, Hovingh GK, Kastelein JJP, Rubba P, Ali S, Banerjee P, Chan KC, Gipe DA, Khilla N, Pordy R, Weinreich DM, Yancopoulos GD, Zhang Y, Gaudet D, HoFH ELIPSE, Investigators. Evinacumab for homozygous familial hypercholesterolemia. N Engl J Med. 2020;383:711–20.

    Article  CAS  PubMed  Google Scholar 

  51. Mohamed F, Botha TC, Raal FJ. Inhibition of angiopoietin-like 3 for the management of severe hypercholesterolemia. Curr Opin Lipidol. 2021;32:213–8.

    Article  CAS  PubMed  Google Scholar 

  52. Gaudet D, Karwatowska-Prokopczuk E, Baum SJ, Hurh E, Kingsbury J, Bartlett VJ, Figueroa AL, Piscitelli P, Singleton W, Witztum JL, Geary RS, Tsimikas S, O'Dea LSL. Vupanorsen Study Investigators. Vupanorsen, an N-acetyl galactosamine-conjugated antisense drug to ANGPTL3 mRNA, lowers triglycerides and atherogenic lipoproteins in patients with diabetes, hepatic steatosis, and hypertriglyceridaemia. Eur Heart J. 2020;41:3936–45.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  53. Chan DC, Watts GF. Metabolism of lipoprotein(a): new findings, implications and outstanding issues. Curr Opin Lipidol. 2020;31:163–5.

    Article  CAS  PubMed  Google Scholar 

  54. Alexander HN, Kristin SL, Christopher OL, Bob S, Wolfram D, Ulf L, et al. Lipoprotein (a) as a risk factor for ischemic stroke: a meta-analysis. Atherosclerosis. 2015;242(2):496–503.

    Article  CAS  Google Scholar 

  55. Kumar P, Swarnkar P, Misra S, Nath M. Lipoprotein (a) level as a risk factor for stroke and its subtype: a systematic review and meta-analysis. Sci Rep. 2021;11:15660.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  56. Martinez LO, Perret B, Genoux A. Update on proprotein convertase subtilisin/kexin type 9 inhibitors, lipoprotein(a) and cardiovascular risk. Curr Opin Lipidol. 2021;32:324–7.

    Article  CAS  PubMed  Google Scholar 

  57. Hardy J, Niman S, Goldfaden RF, Ashchi M, Bisharat M, Huston J, Hartmann H, Choksi R. A review of the clinical pharmacology of pelacarsen: a lipoprotein(a)-lowering agent. Am J Cardiovasc Drugs. 2022;22:47–54.

    Article  CAS  PubMed  Google Scholar 

  58. Koren MJ, Moriarty PM, Baum SJ, Neutel J, Hernandez-Illas M, Weintraub HS, Florio M, Kassahun H, Melquist S, Varrieur T, Haldar SM, Sohn W, Wang H, Elliott-Davey M, Rock BM, Pei T, Homann O, Hellawell J, Watts GF. Preclinical development and phase 1 trial of a novel siRNA targeting lipoprotein(a). Nat Med. 2022;28:96–103.

    Article  CAS  PubMed  Google Scholar 

  59. Nissen SE, Wolski K, Balog C, et al. Single ascending dose study of a short interfering RNA targeting Lipoprotein(a) production in individuals with elevated plasma lipoprotein(a) levels. JAMA Published online April. 2022;03. https://doi.org/10.1001/jama.2022.5050.

  60. Georgakis MK, Gill D. Mendelian randomization studies in stroke: exploration of risk factors and drug targets with human genetic data. Stroke. 2021;52:2992–3003.

    Article  PubMed  Google Scholar 

  61. Lazarte J, Hegele RA. Volanesorsen for treatment of familial chylomicronemia syndrome. Expert Rev Cardiovasc Ther. 2021;19:685–93.

    Article  CAS  PubMed  Google Scholar 

  62. Gouni-Berthold I, Alexander VJ, Yang Q, Hurh E, Steinhagen-Thiessen E, Moriarty PM, Hughes SG, Gaudet D, Hegele RA, O'Dea LSL, Stroes ESG, Tsimikas S, Witztum JL, group Cs. Efficacy and safety of volanesorsen in patients with multifactorial chylomicronaemia (COMPASS): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trial. Lancet Diabetes Endocrinol. 2021;9:264–75.

    Article  CAS  PubMed  Google Scholar 

  63. Tardif JC, Karwatowska-Prokopczuk E, Amour ES, Ballantyne CM, Shapiro MD, Moriarty PM, Baum SJ, Hurh E, Bartlett VJ, Kingsbury J, Figueroa AL, Alexander VJ, Tami J, Witztum JL, Geary RS, O'Dea LSL, Tsimikas S, Gaudet D. Apolipoprotein C-III reduction in subjects with moderate hypertriglyceridaemia and at high cardiovascular risk. Eur Heart J. 2022; Jan 13:ehab820.

  64. Hegele RA. Apolipoprotein C-III inhibition to lower triglycerides: one ring to rule them all? Eur Heart J. 2022;17:ehab890. https://doi.org/10.1093/eurheartj/ehab890.

    Article  Google Scholar 

  65. Pradhan AD, Paynter NP, Everett BM, Glynn RJ, Amarenco P, Elam M, Ginsberg H, Hiatt WR, Ishibashi S, Koenig W, Nordestgaard BG, Fruchart JC, Libby P, Ridker PM. Rationale and design of the Pemafibrate to Reduce Cardiovascular Outcomes by Reducing Triglycerides in Patients with Diabetes (PROMINENT) study. Am Heart J. 2018;206:80–93.

    Article  CAS  PubMed  Google Scholar 

  66. Lee M, Cheng C, Wu Y, Lee J, Hsu C, Ovbiagele B. Association between intensity of low-density lipoprotein cholesterol reduction with statin-based therapies and secondary stroke prevention: a meta-analysis of randomized clinical trials. JAMA Neurol. 2022;79:349–58.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

R.A.H. is supported by the Jacob J. Wolfe Distinguished Medical Research Chair, the Edith Schulich Vinet Research Chair, and the Martha G. Blackburn Chair in Cardiovascular Research. R.A.H. holds operating grants from the Canadian Institutes of Health Research (Foundation Award), the Heart and Stroke Foundation of Ontario (G-21-0031455), and the Academic Medical Association of Southwestern Ontario (INN21-011).

Author information

Authors and Affiliations

  1. Division of Clinical Pharmacology, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, Room 100K-2, Siebens Drake Bldg, 1400 Western Rd, London, Ontario, N6G 2V2, Canada

    Daniel G. Hackam

  2. Department of Epidemiology and Biostatistics, Western University, London, Canada

    Daniel G. Hackam

  3. Department of Clinical Neurological Sciences, Western University, London, Canada

    Daniel G. Hackam

  4. Division of Endocrinology and Metabolism, Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Canada

    Robert A. Hegele

Authors
  1. Daniel G. Hackam
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Robert A. Hegele
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniel G. Hackam.

Ethics declarations

Conflict of Interest

R.A.H. reports consulting fees from Acasti, Aegerion, Akcea/Ionis, Amgen, HLS Therapeutics, Novartis, Pfizer, Regeneron, and Sanofi.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Stroke

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hackam, D.G., Hegele, R.A. Lipid-Modifying Therapies and Stroke Prevention. Curr Neurol Neurosci Rep 22, 375–382 (2022). https://doi.org/10.1007/s11910-022-01197-4

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11910-022-01197-4

Keywords

Search

Navigation