Why the study?
Statins reduce recurrent stroke and mortality in ischemic stroke, but their effects on atrial fibrillation-related stroke are not well-established.
Does statin therapy reduce mortality and improve clinical outcomes in patients with atrial fibrillation-related stroke?
Does statin therapy reduce mortality and improve clinical outcomes in patients with atrial fibrillation-related stroke?
Statin therapy in patients with atrial fibrillation-related stroke is associated with reduced all-cause mortality and improved short-term functional outcomes, though it does not significantly reduce recurrent ischemic stroke or MACE.
May improve survival and function after AF-related stroke; leaves open need for RCTs to confirm beyond anticoagulation.
Background: Statins lower the risk of recurrent stroke and mortality and improve outcomes in patients with ischemic stroke. However, the effects of statins on atrial fibrillation (AF)-related stroke are not well-established. Our study aims to investigate the effects of statin therapy on the clinical outcomes in patients with AF-related stroke. Methods: Electronic databases (MEDLINE, Embase, and Scopus) were searched for previous studies on the effects of pre- and post-stroke statins on the clinical outcomes in AF-related stroke patients. The primary outcome was all-cause mortality. Secondary outcomes included recurrent ischemic stroke, acute coronary events, major adverse cardiovascular events (MACE), and short-term functional outcomes. We extracted hazard ratios (HRs) or odds ratios (ORs) with 95% confidence interval (CI) from each study and pooled them through a meta-analysis. Results: A total of eight studies (five on post-stroke statins and three on pre-stroke statins) with 12,216 patients were included in the analysis. Post-stroke statin therapy reduced the risk of all-cause mortality (HR, 0.63; 95% CI, 0.55–0.74). This beneficial effect was sustained regardless of statin intensity. However, no significant associations were observed between statin therapy and a reduction in the risk of recurrent ischemic stroke, acute coronary events, or MACE. Pre-stroke statin use was associated with a lower risk of poor short-term functional outcomes (OR, 0.63; 95% CI, 0.47–0.85). Conclusions: Statin therapy for AF-related stroke may reduce all-cause mortality and improve functional outcomes. Randomized controlled studies are warranted to confirm the effects of statins on the outcomes of AF-related stroke.
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Eun et al. (2020) studied this question.
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