Statin use and functional outcome after tissue plasminogen activator treatment in acute ischaemic stroke

Cerebrovasc Dis. 2010 Feb;29(3):263-7. doi: 10.1159/000275500. Epub 2010 Jan 15.

Abstract

Background: Preliminary findings suggest that statins may have a neuroprotective effect in patients with acute ischaemic stroke. This study investigated whether patients on prior statin therapy and treated with tissue plasminogen activator (tPA) for acute ischaemic stroke have a better functional outcome than statin-naïve patients.

Methods: In a prospective observational cohort study of 476 acute ischaemic stroke patients treated with tPA we investigated the relationship between prior statin use and functional outcome at 3 months, the occurrence of symptomatic intracerebral haemorrhage (SICH) and early in-hospital mortality. Ischaemic stroke subtypes were defined according to the TOAST classification. Favourable outcome was defined as a modified Rankin Scale score < or =2.

Results: Of the 476 patients included, 98 (20.6%) used a statin at stroke presentation. In the entire cohort, 45.6% of patients had a favourable outcome with no difference between patients with or without statin therapy (45.9 vs. 45.5%, p = 0.94). In the multivariable analysis, statin use was not associated with favourable outcome (OR = 1.1, 95% CI = 0.6-1.9, p = 0.87). In none of the different stroke subtype groups was statin use associated with favourable outcome. Finally, statin use was not an independent risk factor of SICH or of early in-hospital mortality.

Conclusion: Prior statin therapy in patients with acute ischaemic stroke treated with tPA is not associated with a more favourable outcome, and this is independent of stroke subtype.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Ischemia / complications
  • Brain Ischemia / drug therapy*
  • Brain Ischemia / mortality
  • Brain Ischemia / physiopathology
  • Chi-Square Distribution
  • Databases as Topic
  • Disability Evaluation
  • Female
  • Fibrinolytic Agents / administration & dosage*
  • Hospital Mortality
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Intracranial Hemorrhages / etiology
  • Intracranial Hemorrhages / prevention & control
  • Logistic Models
  • Male
  • Middle Aged
  • Neuroprotective Agents / therapeutic use*
  • Odds Ratio
  • Prospective Studies
  • Recovery of Function
  • Risk Assessment
  • Risk Factors
  • Stroke / drug therapy*
  • Stroke / etiology
  • Stroke / mortality
  • Stroke / physiopathology
  • Thrombolytic Therapy*
  • Time Factors
  • Tissue Plasminogen Activator / administration & dosage*
  • Treatment Outcome

Substances

  • Fibrinolytic Agents
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Neuroprotective Agents
  • Tissue Plasminogen Activator