Key result
Statins linked to lower post-stroke Ox-LDL, with each unit predicting ~9% greater risk of poor outcomes.
Why the study?
Does statin therapy reduce oxidized LDL levels and improve outcomes in patients with acute ischemic stroke?
Cohort (n=120)
Single-blind
No
Does statin therapy reduce oxidized LDL levels and improve outcomes in patients with acute ischemic stroke?
p-value: p=<0.01
Statin therapy reduces plasma Ox-LDL levels after acute ischemic stroke, and admission Ox-LDL is an independent predictor of 3-month clinical outcome.
Statin-associated Ox-LDL reduction may benefit acute ischemic stroke patients; leaves open whether targeting Ox-LDL improves outcomes in RCTs.
INTRODUCTION: Statins are reported to have anti-inflammatory and anti-oxidative effects aside from cholesterol-lowering effects. This study aimed to evaluate the effects of statin therapy on oxidized LDL (Ox-LDL) and the clinical outcome of patients with acute ischemic stroke (AIS). METHODS: This prospective study enrolled 120 patients with AIS divided in the statin (n = 55) and non-statin (n = 65) groups. Eighty sex- and age- matched participants were recruited as risk controls. Ox-LDL was measured using a monoclonal antibody-based enzyme-linked immune-sorbent assay at different time points after AIS. The clinical outcomes were analyzed between the statin and non-statin groups. RESULTS: Plasma Ox-LDL was significantly higher in stroke patients than in the controls (P < 0.001). Plasma Ox-LDL level was significantly reduced in the statin group on day 7 and day 30 compared to the non-statin group (P < 0.01). The plasma Ox-LDL positively correlated with serum total cholesterol, LDL-cholesterol, and hemoglobin A1c (HbA1c). Among the potential risk factors, only National Institutes of Health stroke scale (NIHSS) score and Ox-LDL level on admission were independently associated with 3-month outcome. CONCLUSIONS: Our study demonstrates that statin therapy reduces plasma Ox-LDL level after AIS. Plasma Ox-LDL may be a more powerful predictor than serum LDL, high-sensitivity C-reactive protein or white blood cell counts for stroke outcome. Therefore, assay of plasma Ox-LDL should be added as a predictor among the panel of conventional biomarkers in stroke outcome.
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Tsai et al. (2014) conducted a cohort in Acute ischemic stroke (AIS) (n=120). Statin therapy vs. Non-statin therapy was evaluated on Plasma Ox-LDL level on day 7 and day 30 post-stroke (p=<0.01). Statin therapy significantly reduced plasma Ox-LDL levels on day 7 and day 30 after acute ischemic stroke compared to non-statin therapy (P < 0.01), and each 1 U/L increase in admission Ox-LDL independently predicted poor 3-month outcome (OR 1.09).
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