Published Online
on February 1, 2007

A more recent version of this article appeared on March 1, 2007

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Submitted on January 30, 2006
Revised on October 12, 2006
Accepted on October 17, 2006

Prior Statin Use May Be Associated With Improved Stroke Outcome After Tissue Plasminogen Activator

José Álvarez-Sabín MD, PhD; Rafael Huertas MD; Manolo Quintana; Marta Rubiera MD; Pilar Delgado MD; Marc Ribó MD, PhD; Carlos A. Molina MD, PhD; and Joan Montaner MD, PhD^*

From the Neurovascular Research Laboratory, Neurovascular Unit, Neurology Department, Hospital Universitario Vall d’Hebron, Barcelona, Spain.

^* To whom correspondence should be addressed. E-mail: 31862jmv{at}comb.es.

Background and Purpose--Statins may exert some neuroprotection, because use before stroke onset has been related to better outcome and reduced mortality. The purpose of this study was to evaluate whether patients who receive tissue plasminogen activator have better outcome when statins were taken before stroke.

Methods--We evaluated 145 patients with a stroke involving the middle cerebral artery (who received tissue plasminogen activator treatment (<3 hours).

Results--Fifty-eight patients (40%) became functionally independent at 3 months. Factors associated with good outcome were age (68 versus 74.4 years, P<0.001), baseline National Institutes of Health Stroke Scale score (13 versus 18, P<0.001), and proximal middle cerebral artery occlusion (56.1% versus 84.3%, P<0.001). Statins were the only drug taken before stroke that conditioned neurologic outcome. In fact, among patients who were functionally independent, 27.3% were under statins at the time of the index stroke as compared with 13.6% among the group of patients who were dependent or dead by the end of the study period (P=0.046). A logistic regression model identified baseline National Institutes of Health Stroke Scale score <15 (OR: 5.8, 95% CI: 2.05 to 16.36, P=0.001), age <70 years (OR: 2.93, 95% CI: 1.13 to 7.59, P=0.027), and previous treatment with statins (OR: 5.26, 95% CI: 1.48 to 18.72, P=0.027) as independent predictors of good functional outcome.

Conclusions--Patients under statins at the moment of stroke who received thrombolytics had an improved neurologic outcome.

Key words: neuroprotection • statin • stroke • thrombolysis • t-PA

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