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Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
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Statins Use and Outcome of Acute Ischemic Stroke Patients after Systemic Thrombolysis

Ashkan Mowla1, Harshit Shah2, Navdeep Singh Lail2

  • 1Division of Endovascular Neurosurgery, Department of Neurological Surgery, Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA, mowla@usc.edu.

Cerebrovascular Diseases (Basel, Switzerland)
|September 14, 2020
PubMed

Insights

Prior statin use did not significantly impact symptomatic intracranial hemorrhage (sICH) or outcomes after acute ischemic stroke (AIS) treatment with IV thrombolysis (IVT). Statin intensity also showed no significant effect on sICH risk or outcomes.

Area of Science:

  • Neurology
  • Cardiology
  • Pharmacology

Background:

  • Acute ischemic stroke (AIS) is a leading cause of disability and mortality.
  • Intravenous thrombolysis (IVT) is a critical treatment for AIS, but carries risks like symptomatic intracranial hemorrhage (sICH).
  • Statins are commonly used to manage cardiovascular risk factors, but their effect on AIS outcomes post-IVT is not fully understood.

Purpose of the Study:

  • To investigate the impact of prior statin use on the risk of sICH after IVT for AIS.
  • To evaluate the association between statin intensity (high vs. low) and sICH risk and patient outcomes.
  • To determine if statin therapy influences functional outcomes, measured by the modified Rankin Scale, following IVT for AIS.

Main Methods:

  • Retrospective analysis of 834 patients treated with IVT for AIS over a 10-year period.
  • Patients were categorized into statin users and non-users, and statin users were further classified by intensity (high vs. low).
  • Outcomes, including sICH and discharge modified Rankin Scale scores, were compared across groups using multivariate logistic regression, adjusting for relevant clinical factors.

Main Results:

  • No significant association was found between any statin use and the odds of sICH (OR = 0.52, p = 0.06) or poor outcome (OR = 1.01, p = 0.57).
  • High-intensity statin use showed a trend towards reduced odds of poor outcome (OR = 0.53, p = 0.01) compared to low-intensity statins, but this did not reach statistical significance in multivariate analysis (OR = 0.60, p = 0.07).
  • Statin intensity did not significantly affect the odds of sICH compared to low-intensity statins (OR = 0.39, p = 0.15).

Conclusions:

  • Prior statin therapy does not appear to significantly increase the risk of sICH or negatively impact outcomes after IVT for AIS.
  • Statin intensity did not demonstrate a significant association with sICH risk or functional outcomes in this cohort.
  • Further research may be warranted to explore potential benefits of high-intensity statins on functional recovery post-AIS, although current findings require cautious interpretation due to loss of significance in multivariate models.
Abstract

Keywords:
IV thrombolysisStatinStroke

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