Key result
Pre-existing statin use prior to acute non-cardio-embolic ischemic stroke was independently associated with a significantly higher likelihood of good clinical outcome at three months (OR 4.82).
Why the study?
Does pre-existing statin use reduce platelet activation and improve clinical outcomes in patients with acute non-cardio-embolic ischemic stroke?
Cohort (n=172)
No
Does pre-existing statin use reduce platelet activation and improve clinical outcomes in patients with acute non-cardio-embolic ischemic stroke?
Odds Ratio: 4.82 (95% CI 1.22–19.03)
Absolute Event Rate: 90.7% vs 72.9%
p-value: p=0.025
Pre-existing statin use in patients with acute non-cardio-embolic ischemic stroke is associated with decreased platelet activation and improved 3-month clinical outcomes.
May support better 3-month outcomes in observational stroke cohorts; leaves open confirmation of causality in randomized trials.
INTRODUCTION: Statins reportedly have anti-inflammatory and anti-thrombotic effects aside from cholesterol-lowering. This study aimed to evaluate the effect of pre-existing statin use on platelet activation markers and clinical outcome in acute ischemic stroke patients. METHODS: This prospective study evaluated 172 patients with acute ischemic stroke divided in two groups: patients with pre-existing statin (n = 43) and without pre-existing statin (66 cases with statins initiated post-stroke and 63 without statin treatment). Platelet activation markers (CD62P and CD63) were measured by flow cytometry at different time points after stroke and analyzed with clinical outcome. RESULTS: The CD62P and CD63 expressions on platelets were significantly lower in the patients with pre-existing statin use compared to the patients without pre-existing statin use on Day 1 post-stroke (p < 0.05). The CD62P expression was significantly lower in the patients with pre-existing statin use on 90 days after the acute stroke (p < 0.05). Patients with pre-existing statin use had lower incidences of early neurologic deterioration (END) than those without treatment (p < 0.05). Among several baseline clinical variables, admission NIHSS score, history of coronary artery disease, and pre-existing statin use were independent predictions of good clinical outcome at three months. CONCLUSIONS: Pre-existing statin use is associated with decreased platelet activity as well as improved clinical outcome and reduced END in patients with acute ischemic stroke.
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Tsai et al. (2011) conducted a cohort in Acute non-cardio-embolic ischemic stroke (n=172). Pre-existing statin use vs. No pre-existing statin use was evaluated on Good clinical outcome at 3 months (mRS 0-2) (OR 4.82, 95% CI 1.22-19.03, p=0.025). Pre-existing statin use prior to acute non-cardio-embolic ischemic stroke was independently associated with a significantly higher likelihood of good clinical outcome at three months (OR 4.82).
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