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Effect of pre-stroke statin use on stroke severity and early functional recovery: a retrospective cohort study

Cited 17 time in Web of Science Cited 16 time in Scopus
Authors
Choi, Jay Chol; Lee, Ji Sung; Park, Tai Hwam; Cho, Yong-Jin; Park, Jong-Moo; Kang, Kyusik; Lee, Kyung Bok; Lee, Soo-Joo; Ko, Youngchai; Lee, Jun; Kim, Joon-Tae; Yu, Kyung-Ho; Lee, Byung-Chul; Cha, Jae-Kwan; Kim, Dae-Hyun; Lee, Juneyoung; Kim, Dong-Eog; Jang, Myung Suk; Kim, Beom Joon; Han, Moon-Ku; Bae, Hee-Joon; Hong, Keun-Sik
Issue Date
2015-07-30
Publisher
BioMed Central
Citation
BMC Neurology, 15(1):120
Keywords
Acute strokeStatinsOutcomes
Description
This is an Open Access article distributed under the terms of the Creative Commons Attribution License
(http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium,
provided the original work is properly credited.
Abstract
Abstract

Background
Experimental studies suggest that pre-stroke statin treatment has a dual effect of neuroprotection during ischemia and neurorestoration after ischemic injury. The aim of this study was to evaluate the effect of pre-stroke statin use on initial stroke severity and early clinical outcome.


Methods
We used a prospective database enrolling patients with acute ischemic stroke from 12 hospitals in Korea between April 2008 and January 2012. Primary endpoint was the initial stroke severity as measured by the National Institutes of Health Stroke Scale (NIHSS) score. Secondary endpoints were good outcome (modified Rankin Scale [mRS], 0–2) and overall mRS distribution at discharge. Multivariable regression model and propensity score (PS) matching were used for statistical analyses.


Results
Among the 8340 patients included in this study, 964 patients (11.6 %) were pre-stroke statin users. The initial NIHSS score (mean [95 % CI]) was lower among pre-stroke statin users vs. non-users in multivariable analysis (5.7 [5.2–6.3] versus 6.4 [5.9–6.9], p = 0.002) and PS analysis (5.2 [4.7–5.7] versus 5.7 [5.4–6.0], p = 0.043). Pre-stroke statin use was associated with increased achievement of mRS 0–2 outcome (multivariable analysis: OR [95 % CI], 1.55 [1.25–1.92], p < 0.001; PS matching: OR [95 % CI], 1.47 [1.16-1.88]; p = 0.002) and favorable shift on the overall mRS distribution (multivariable analysis: OR [95 % CI], 1.29 [1.12-1.51], p = 0.001; PS matching: OR [95 % CI], 1.31 [1.11-1.54]; p = 0.001).


Conclusions
Pre-stroke statin use was independently associated with lesser stroke severity at presentation and better early functional recovery in patients with acute ischemic stroke.
Language
English
URI
https://hdl.handle.net/10371/100551
DOI
https://doi.org/10.1186/s12883-015-0376-3
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Neurology (신경과학교실)Journal Papers (저널논문_신경과학교실)
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