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Role of statin in atrial fibrillation-related stroke: an angiographic study for collateral flow

Mi Ji Lee1, Oh Young Bang, Suk Jae Kim

  • 1Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

Cerebrovascular Diseases (Basel, Switzerland)
|January 25, 2014
PubMed

Insights

Statin use before stroke in atrial fibrillation (AF) patients was linked to better collateral blood flow. This suggests statins might benefit AF-related cardioembolic stroke, despite trial exclusions.

Area of Science:

  • Neurology
  • Cardiology
  • Pharmacology

Background:

  • Intensive lipid lowering is standard for atherosclerotic stroke.
  • The role of statins in cardioembolic stroke remains unclear.
  • This study examines statin association with collateral status in cardioembolic stroke.

Purpose of the Study:

  • To investigate the relationship between statin use and pretreatment collateral status in patients with cardioembolic stroke.
  • To assess if statin use influences collateral circulation in acute middle cerebral artery infarction due to atrial fibrillation.

Main Methods:

  • A collaborative study included 98 patients with acute middle cerebral artery infarction due to atrial fibrillation (AF).
  • Cerebral angiography was used to evaluate angiographic collateral grade (ASITN/SIR system).
  • The association between collateral grade and statin use/dose at stroke onset was analyzed.

Main Results:

  • Statin users (22/98) were older and had more comorbidities than statin-naïve patients (76/98).
  • Excellent collaterals (grade 3-4) were more frequent in statin users (50%) versus statin-naïve patients (27.6%; p=0.049).
  • Prestroke statin use was independently associated with excellent collaterals (OR, 7.841; p=0.004).

Conclusions:

  • Premorbid statin use in AF patients correlates with excellent collateral flow.
  • Findings suggest potential benefits of statins in AF-related cardioembolic stroke.
  • Further research is warranted given trial exclusions of cardioembolic stroke patients.
Abstract

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