Renal Function-Dependent Associations of Statins with Outcomes of Ischemic Stroke

Area of Science:

• Nephrology
• Neurology
• Cardiology

Background:

• Chronic kidney disease (CKD) significantly worsens outcomes for ischemic stroke patients.
• Dyslipidemia, common in CKD, is a modifiable risk factor treatable with statins.
• Renal function may influence the effectiveness and safety of statin therapy post-stroke.

Purpose of the Study:

• To investigate if estimated glomerular filtration rate (eGFR) modifies the association between statin therapy and outcomes in ischemic stroke patients.
• To analyze the impact of statins on mortality, functional status, and stroke recurrence stratified by renal function.

Main Methods:

• Retrospective analysis of 50,092 acute ischemic stroke patients from the Taiwan Stroke Registry (August 2006 - May 2016).
• Evaluation of statin therapy at discharge and its association with 3-month outcomes: mortality, modified Rankin Scale (mRS), and recurrent ischemic stroke.
• Stratification of patients based on eGFR levels to assess outcome differences.

Main Results:

• Statin therapy was linked to reduced mortality (aHR, 0.41) and unfavorable functional outcomes (aHR, 0.80) overall.
• The mortality benefit of statins was observed only in patients with eGFR > 15 mL/min/1.73 m².
• Statin use was associated with better functional outcomes (mRS 3-5) in patients with eGFR 60-89 mL/min/1.73 m², but also a higher risk of recurrent stroke (aHR, 1.29).

Conclusions:

• The association of statins with mortality and functional outcomes following ischemic stroke is significantly dependent on the patient's estimated glomerular filtration rate (eGFR).
• Renal function is a critical factor to consider when prescribing statins to ischemic stroke patients, potentially affecting treatment benefits and risks.