Association between acute statin therapy, survival, and improved functional outcome after ischemic stroke: the North Dublin Population Stroke Study.
AuthorsNí Chróinín, Danielle
Callaly, Elizabeth L
Williams, Emma B
McCormack, Patricia M E
Kelly, Peter J
AffiliationNeurovascular Clinical Science Unit, Catherine McCauley Research Centre, Mater University Hospital, Nelson Street, Dublin 7, Ireland. firstname.lastname@example.org
Aged, 80 and over
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Recovery of Function
MetadataShow full item record
CitationAssociation between acute statin therapy, survival, and improved functional outcome after ischemic stroke: the North Dublin Population Stroke Study. 2011, 42 (4):1021-9 Stroke
JournalStroke; a journal of cerebral circulation
AbstractStatins improve infarct volume and neurological outcome in animal stroke models. We investigated the relationship between statin therapy and ischemic stroke outcome in the North Dublin Population Stroke Study.
A population-based prospective cohort study was performed using rigorous ascertainment methods. Prestroke and acute (≤72 hours) poststroke medications were recorded. Modified Rankin score and fatality were assessed at 7, 28, and 90 days and 1 year.
Of 448 ischemic stroke patients, statins were prescribed before stroke onset in 30.1% (134/445) and were begun acutely (≤72 hours) in an additional 42.5% (189/445). On logistic regression analysis, adjusting for age, prestroke disability (modified Rankin scale), NIHSS score, hypertension, and aspirin, new poststroke statin therapy was independently associated with improved early and late survival (compared with statin untreated patients: OR for death, 0.12; CI, 0.03-0.54 at 7 days; OR, 0.19; CI, 0.07-0.48 at 90 days; OR, 0.26; CI, 0.12-0.55 at 1 year; P≤0.006 for all). Similar findings were observed for statin therapy before stroke onset (adjusted OR for death compared with statin-untreated-patients, 0.04; CI, 0.00-0.33; P=0.003 at 7 days; OR, 0.23; CI, 0.09-0.58; P=0.002 at 90 days; OR, 0.48; CI, 0.23-1.01; P=0.05 at 1 year).
Statin therapy at stroke onset and newly begun statins were associated with improved early and late outcomes, supporting data from experimental studies. Randomized trials of statin therapy for treatment of acute stroke are needed.