TY - JOUR
T1 - Statins in Ischemic Stroke
T2 - Just Low-Density Lipoprotein Lowering or More?
AU - Stead, Latha G.
AU - Vaidyanathan, Lekshmi
AU - Kumar, Gautam
AU - Bellolio, M. Fernanda
AU - Brown, Robert D.
AU - Suravaram, Smitha
AU - Enduri, Sailaja
AU - Gilmore, Rachel M.
AU - Decker, Wyatt W.
PY - 2009/3
Y1 - 2009/3
N2 - Background: Statins have been shown to improve the functional outcome of patients after an ischemic stroke. We hypothesized that daily statin intake improves functional outcome after an acute ischemic stroke in patients with low-density lipoprotein (LDL) less than or equal to 100 mg/dL. Methods: This was a prospective cohort study during a 22-month period of patients presenting with an acute ischemic stroke and lipid profiles measured. The functional disability was determined using modified Rankin scale score (0-2 good outcome, 3-6 bad outcome) at discharge. Chi-square test for binary data and nonparametric tests for nonnormally distributed variables were used for analysis. Results: Of 508 patients, 207 presented with an LDL of 100 mg/dL or less and were included in the analysis. There was no significant difference in admission stroke severity (National Institutes of Health Stroke Scale [NIHSS]; P = .18), age (P = .31), and sex (P = .06) between those taking statins and not taking statins. Patients with LDL less than or equal to 100 mg/dL and taking statins (n = 100) were significantly more likely to have a good functional outcome (odds ratio 1.91; 95% confidence interval 1.05-3.47) when compared with those not on the medication. After adjusting for age, sex, and NIHSS, statin intake still predicted a better functional outcome (P < .0001). Conclusion: Daily statin intake appears to result in a better functional outcome after an ischemic stroke in patients with ideal LDL levels (≤100 mg/dL) before and after adjusting for age and stroke severity. Pleiotropic effects of statins may play a role in this.
AB - Background: Statins have been shown to improve the functional outcome of patients after an ischemic stroke. We hypothesized that daily statin intake improves functional outcome after an acute ischemic stroke in patients with low-density lipoprotein (LDL) less than or equal to 100 mg/dL. Methods: This was a prospective cohort study during a 22-month period of patients presenting with an acute ischemic stroke and lipid profiles measured. The functional disability was determined using modified Rankin scale score (0-2 good outcome, 3-6 bad outcome) at discharge. Chi-square test for binary data and nonparametric tests for nonnormally distributed variables were used for analysis. Results: Of 508 patients, 207 presented with an LDL of 100 mg/dL or less and were included in the analysis. There was no significant difference in admission stroke severity (National Institutes of Health Stroke Scale [NIHSS]; P = .18), age (P = .31), and sex (P = .06) between those taking statins and not taking statins. Patients with LDL less than or equal to 100 mg/dL and taking statins (n = 100) were significantly more likely to have a good functional outcome (odds ratio 1.91; 95% confidence interval 1.05-3.47) when compared with those not on the medication. After adjusting for age, sex, and NIHSS, statin intake still predicted a better functional outcome (P < .0001). Conclusion: Daily statin intake appears to result in a better functional outcome after an ischemic stroke in patients with ideal LDL levels (≤100 mg/dL) before and after adjusting for age and stroke severity. Pleiotropic effects of statins may play a role in this.
KW - Brain
KW - cholesterol
KW - ischemia
KW - ischemic stroke
KW - low-density lipoprotein
KW - statins
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U2 - 10.1016/j.jstrokecerebrovasdis.2008.09.016
DO - 10.1016/j.jstrokecerebrovasdis.2008.09.016
M3 - Article
C2 - 19251188
AN - SCOPUS:60949086201
SN - 1052-3057
VL - 18
SP - 124
EP - 127
JO - Journal of Stroke and Cerebrovascular Diseases
JF - Journal of Stroke and Cerebrovascular Diseases
IS - 2
ER -