Does statin in the acute phase of ischemic stroke improve outcome after intravenous thrombolysis? A retrospective study.

Abstract

BACKGROUND:

In recent years, the medical literature has shown that statin treatment before and in the acute phase of ischemic stroke has a positive impact on outcome. The possible effect of statins during the acute phase has never been assessed in thrombolysed patients, and the few studies investigating a possible association between prior statin use and outcome after thrombolysis have reported controversial results. The aim of the present study was to assess whether statin treatment started in the acute phase of stroke (within 24h) or before stroke and continued during the acute phase may influence short- and long-term outcome in patients receiving intravenous (IV) thrombolysis.

METHODS:

We conducted a retrospective analysis of 250 patients treated with IV thrombolysis. Outcome measures were 3-month good functional outcome (modified Rankin Scale ≤ 2); neurological improvement (reduction ≥ 4 points on the National Institutes of Health Stroke Scale [NIHSS]) between 24 and 72 h; and symptomatic intracerebral hemorrhage (brain hematoma associated with NIHSS deterioration ≥ 4 points) within 72 h.

RESULTS:

Multivariate analysis showed that statin treatment started in the acute phase of stroke was associated with both good functional outcome (OR: 6.18; 95% CI: 1.43-26.62; P=0.015) and neurological improvement (OR: 9.47; 95% CI: 1.98-45.37; P=0.005), whereas statin treatment started before stroke and continued in the acute phase was associated with symptomatic intracerebral hemorrhage (OR: 6.65; 95% CI: 1.58-29.12; P=0.010).

CONCLUSIONS:

Our data suggest that statin treatment started within 24h after IV thrombolysis, but not statin treatment started before stroke and continued in the acute phase, may improve short- and long-term outcome.

• Authors: Manuel Cappellari, Cristina Deluca, Michele Tinazzi, Giampaolo Tomelleri, Monica Carletti, Antonio Fiaschi, Paolo Bovi, Giuseppe Moretto
• Journal: Journal of the neurological sciences (J Neurol Sci) Vol. 308 Issue 1-2 Pg. 128-34 (Sep 15 2011) ISSN: 1878-5883 [Electronic] Netherlands
• PMID: 21683374 (Publication Type: Comparative Study, Journal Article)
• Copyright: Copyright © 2011 Elsevier B.V. All rights reserved.

Chemical References

• Hydroxymethylglutaryl-CoA Reductase Inhibitors

Topics

• Aged
• Aged, 80 and over
• Female
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (administration & dosage, therapeutic use)
• Infusions, Intravenous
• Male
• Middle Aged
• Retrospective Studies
• Stroke (blood, drug therapy, physiopathology)
• Thrombolytic Therapy (methods)
• Time Factors
• Treatment Outcome