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Rising statin use and effect on ischemic stroke outcome
Sung Sug Yoon1, James Dambrosia, Julio Chalela
1Stroke Neuroscience Unit, NINDS/NIH, Bethesda, MD 20892, USA. sungsyoon@yahoo.com <sungsyoon@yahoo.com>
Insights
Patients taking statins before hospital admission for stroke showed improved outcomes. Statin pretreatment was linked to a significantly better functional recovery at discharge, suggesting potential benefits of early statin initiation post-stroke.
Area of Science:
- Neurology
- Cardiology
- Pharmacology
Background:
- Statins, known for neuroprotective effects in experimental models, are widely used.
- Clinical practice involves common statin prescription for various conditions.
Purpose of the Study:
- To investigate the association between pre-hospital statin use and clinical outcomes in stroke patients.
- To determine if statin therapy prior to stroke admission impacts patient recovery.
Main Methods:
- Observational study of 436 ischemic stroke patients admitted between July 2000 and December 2002.
- Data collected on stroke risk factors, severity (NIH Stroke Scale), and discharge outcomes (Rankin score).
- Univariate and multivariate logistic regression models were employed for statistical analysis.
Main Results:
- 22% of patients (95/433) were on statins pre-admission, with usage increasing from 16% to 26% during the study period.
- Patients on statins had a 51% good outcome rate versus 38% for non-statin users (p=0.03).
- Statin pretreatment showed a 2.9-fold increased odds of good outcome (95% CI: 1.2-6.7) after adjusting for confounders.
Conclusions:
- The prevalence of statin use among admitted stroke patients is rapidly increasing.
- Pre-stroke statin therapy is significantly associated with improved functional outcomes at hospital discharge.
- Findings support the consideration of early statin therapy initiation following stroke.
Background:
Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) have neuroprotective effects in experimental stroke models and are commonly prescribed in clinical practice. The aim of this study was to determine if patients taking statins before hospital admission for stroke had an improved clinical outcome.
Methods:
This was an observational study of 436 patients admitted to the National Institutes of Health Suburban Hospital Stroke Program between July 2000 and December 2002. Self-reported risk factors for stroke were obtained on admission. Stroke severity was determined by the admission National Institutes of Health Stroke Scale score. Good outcome was defined as a Rankin score < 2 at discharge. Statistical analyses used univariate and multivariate logistic regression models.
Results:
There were 436 patients with a final diagnosis of ischemic stroke; statin data were available for 433 of them. A total of 95/433 (22%) of patients were taking a statin when they were admitted, rising from 16% in 2000 to 26% in 2002. Fifty-one percent of patients taking statins had a good outcome compared to 38% of patients not taking statins (p = 0.03). After adjustment for confounding factors, statin pretreatment was associated with a 2.9 odds (95% CI: 1.2-6.7) of a good outcome at the time of hospital discharge.
Conclusions:
The proportion of patients taking statins when they are admitted with stroke is rising rapidly. Statin pretreatment was significantly associated with an improved functional outcome at discharge. This finding could support the early initiation of statin therapy after stroke.
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