Published Online
on April 8, 2004

A more recent version of this article appeared on May 1, 2004

This Article Full Text (PDF) All Versions of this Article: 35/5/1117    most recent 01.STR.0000125863.93921.3fv1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Martí-Fàbregas, J. Articles by Martí-Vilalta, J.-L. Search for Related Content PubMed PubMed Citation Articles by Martí-Fàbregas, J. Articles by Martí-Vilalta, J.-L. Pubmed/NCBI databases Medline Plus Health Information Stroke Related Collections Other Stroke Treatment - Medical Lipid and lipoprotein metabolism Acute Cerebral Infarction

Submitted on October 14, 2003
Revised on January 15, 2005
Accepted on January 22, 2004

Favorable Outcome of Ischemic Stroke in Patients Pretreated with Statins

Joan Martí-Fàbregas MD, PhD^*; Meritxell Gomis MD; Adrià Arboix MD, PhD; Aitziber Aleu MD; Javier Pagonabarraga MD; Robert Belvís MD; Dolores Cocho MD; Jaume Roquer MD, PhD; Ana Rodríguez MD; María Dolores García MD; Laura Molina-Porcel MD; Jordi Díaz-Manera MD; and Josep-Lluis Martí-Vilalta MD, PhD

From Departments of Neurology, Hospital de la Santa Creu i Sant Pau (J.M.-F., A.A., J.P., R.B., D.C., M.D.G., L.M.-P., J.D.-M., J.-L.M.-V.), Hospital Nostra Senyora del Mar (M.G., J.R., A.R.), and Hospital del Sagrat Cor (A.A.), Barcelona, Spain.

^* To whom correspondence should be addressed. E-mail: jmarti{at}hsp.santpau.es.

Background and Purpose--Statins may be beneficial for patients with acute ischemic stroke. We tested the hypothesis that patients pretreated with statins at the onset of stroke have less severe neurological effects and a better outcome.

Methods--We prospectively included consecutive patients with ischemic stroke of <24-hour duration. We recorded demographic data, vascular risk factors, Oxfordshire Classification, National Institutes of Health Stroke Scale (NIHSS) score, admission blood glucose and body temperature, cause (Trial of Org 10172 in Acute Treatment [TOAST] criteria), neurological progression at day 3, previous statin treatment, and outcome at 3 months. We analyzed the data using univariate methods and a logistic regression with the dependent variable of good outcome (modified Rankin Scale [mRS] 0 to 1, Barthel Index [BI] 95 to 100).

Results--We included 167 patients (mean age 70.7±12 years, 94 men). Thirty patients (18%) were using statins when admitted. In the statin group, the median NIHSS score was not significantly lower and the risk of progression was not significantly reduced. Favorable outcomes at 3 months were more frequent in the statin group (80% versus 61.3%, P=0.059 with the mRS; 76.7% versus 51.8%, P=0.015 with the BI). Predictors of favorable outcome with the BI were: NIHSS score at admission (OR: 0.72; CI: 0.65 to 0.80; P<0.0001), age (OR: 0.96; CI: 0.92 to 0.99; P=0.017), and statin group (OR: 5.55; CI: 1.42 to 17.8; P=0.012).

Conclusions--Statins may provide benefits for the long-term functional outcome when administered before the onset of cerebral ischemia. However, randomized controlled trials will be required to evaluate the validity of our results.

Key words: outcome • ischemia • statins

This article has been cited by other articles:

				R. H. Samson The Role of Statin Drugs in the Management of the Peripheral Vascular Patient Vascular and Endovascular Surgery, August 1, 2008; 42(4): 352 - 366. [Abstract] [PDF]

				E. FitzMaurice, L. Wendell, R. Snider, K. Schwab, R. Chanderraj, C. Kinnecom, K. Nandigam, N. S. Rost, A. Viswanathan, J. Rosand, et al. Effect of Statins on Intracerebral Hemorrhage Outcome and Recurrence Stroke, July 1, 2008; 39(7): 2151 - 2154. [Abstract] [Full Text] [PDF]

				M. Rodriguez-Yanez, J. Agulla, R. Rodriguez-Gonzalez, T. Sobrino, and J. Castillo Review: Statins and stroke Therapeutic Advances in Cardiovascular Disease, June 1, 2008; 2(3): 157 - 166. [Abstract] [PDF]

				M. J. Reeves, J. W. Gargano, Z. Luo, A. J. Mullard, B. S. Jacobs, A. Majid, and for the Paul Coverdell National Acute Stroke Regis Effect of Pretreatment With Statins on Ischemic Stroke Outcomes Stroke, June 1, 2008; 39(6): 1779 - 1785. [Abstract] [Full Text] [PDF]

				J. Ponce, N. P. de la Ossa, O. Hurtado, M. Millan, J. F. Arenillas, A. Davalos, and T. Gasull Simvastatin Reduces the Association of NMDA Receptors to Lipid Rafts: A Cholesterol-Mediated Effect in Neuroprotection Stroke, April 1, 2008; 39(4): 1269 - 1275. [Abstract] [Full Text] [PDF]

				R. M. Clarke, A. Lyons, F. O'Connell, B. F. Deighan, C. E. Barry, N. G. Anyakoha, A. Nicolaou, and M. A. Lynch A Pivotal Role for Interleukin-4 in Atorvastatin-associated Neuroprotection in Rat Brain J. Biol. Chem., January 25, 2008; 283(4): 1808 - 1817. [Abstract] [Full Text] [PDF]

				M. Blanco, F. Nombela, M. Castellanos, M. Rodriguez-Yanez, M. Garcia-Gil, R. Leira, I. Lizasoain, J. Serena, J. Vivancos, M. A. Moro, et al. Statin treatment withdrawal in ischemic stroke: A controlled randomized study Neurology, August 28, 2007; 69(9): 904 - 910. [Abstract] [Full Text] [PDF]

				E. Onukwugha and C. D. Mullins Racial Differences in Hospital Discharge Disposition among Stroke Patients in Maryland Med Decis Making, May 1, 2007; 27(3): 233 - 242. [Abstract] [PDF]

				M. A. Moskowitz The 2006 Thomas Willis Lecture: The Adventures of a Translational Researcher in Stroke and Migraine Stroke, May 1, 2007; 38(5): 1645 - 1651. [Full Text] [PDF]

				J. Alvarez-Sabin, R. Huertas, M. Quintana, M. Rubiera, P. Delgado, M. Ribo, C. A. Molina, and J. Montaner Prior Statin Use May Be Associated With Improved Stroke Outcome After Tissue Plasminogen Activator Stroke, March 1, 2007; 38(3): 1076 - 1078. [Abstract] [Full Text] [PDF]

				D. Deplanque, I. Masse, C. Lefebvre, C. Libersa, D. Leys, and R. Bordet Prior TIA, lipid-lowering drug use, and physical activity decrease ischemic stroke severity Neurology, October 24, 2006; 67(8): 1403 - 1410. [Abstract] [Full Text] [PDF]

				M. Endres and U. Laufs Discontinuation of Statin Treatment in Stroke Patients Stroke, October 1, 2006; 37(10): 2640 - 2643. [Abstract] [Full Text] [PDF]

				M. S.V. Elkind, A. C. Flint, R. R. Sciacca, and R. L. Sacco Lipid-lowering agent use at ischemic stroke onset is associated with decreased mortality Neurology, July 26, 2005; 65(2): 253 - 258. [Abstract] [Full Text] [PDF]

				M. Moonis, K. Kane, U. Schwiderski, B. W. Sandage, and M. Fisher HMG-CoA Reductase Inhibitors Improve Acute Ischemic Stroke Outcome Stroke, June 1, 2005; 36(6): 1298 - 1300. [Abstract] [Full Text] [PDF]

				A. B. Singhal, M. A. Topcuoglu, D. J. Dorer, C. S. Ogilvy, B. S. Carter, and W. J. Koroshetz SSRI and statin use increases the risk for vasospasm after subarachnoid hemorrhage Neurology, March 22, 2005; 64(6): 1008 - 1013. [Abstract] [Full Text] [PDF]

				J. Y. Streifler Editorial Comment--Statins, Stroke Outcome, and Stroke Prevention: When Should We Start Treatment? Stroke, May 1, 2004; 35(5): 1121 - 1123. [Full Text] [PDF]