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Abstract
Objective: To assess the impact on stroke outcome of statin use in the acute phase after IV thrombolysis.
Methods: Multicenter study on prospectively collected data of 2,072 stroke patients treated with IV thrombolysis. Outcome measures of efficacy were neurologic improvement (NIH Stroke Scale [NIHSS] ≤ 4 points from baseline or NIHSS = 0) and major neurologic improvement (NIHSS ≤ 8 points from baseline or NIHSS = 0) at 7 days and favorable (modified Rankin Scale [mRS] ≤ 2) and excellent functional outcome (mRS ≤ 1) at 3 months. Outcome measures of safety were 7-day neurologic deterioration (NIHSS ≥ 4 points from baseline or death), symptomatic intracerebral hemorrhage type 2 with NIHSS ≥ 4 points from baseline or death within 36 hours, and 3-month death.
Results: Adjusted multivariate analysis showed that statin use in the acute phase was associated with neurologic improvement (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.26–2.25; p < 0.001), major neurologic improvement (OR 1.43, 95% CI 1.11–1.85; p = 0.006), favorable functional outcome (OR 1.63, 95% CI 1.18–2.26; p = 0.003), and a reduced risk of neurologic deterioration (OR: 0.31, 95% CI 0.19–0.53; p < 0.001) and death (OR 0.48, 95% CI 0.28–0.82; p = 0.007).
Conclusion: Statin use in the acute phase of stroke after IV thrombolysis may positively influence short- and long-term outcome.
GLOSSARY
- CI=
- confidence interval;
- MCA=
- middle cerebral artery;
- mRS=
- modified Rankin Scale;
- NIHSS=
- NIH Stroke Scale;
- OR=
- odds ratio;
- OTT=
- onset to treatment;
- rtPA=
- recombinant tissue plasminogen activator;
- sICH=
- symptomatic intracerebral hemorrhage;
- SITS-MOST=
- Safe Implementation of Thrombolysis in Stroke–Monitoring Study;
- THRaST=
- THRombolysis and STatins study
Footnotes
Go to Neurology.org for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
Supplemental data at www.neurology.org
- Received May 22, 2012.
- Accepted October 8, 2012.
- © 2013 American Academy of Neurology
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