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(Stroke. 2009;40:2581.)
© 2009 American Heart Association, Inc.

Research Letters

Prior Use of Statins Improves Outcome in Patients With Intracerebral Hemorrhage

Prospective Data from the National Acute Stroke Israeli Surveys (NASIS)

Ronen R. Leker, MD; Salim T. Khoury, MD; Guy Rafaeli, MD; Roseline Shwartz, PhD; Roni Eichel, MD; David Tanne, MD on behalf of the NASIS Investigators

From the Department of Neurology (R.R.L., S.K., G.R., R.E.), Cerebrovascular Service and the Periz and Chantal Sheinberg Cerebrovascular Research Laboratory, Hebrew University Hadassah Medical Center, Jerusalem, Israel; and the Department of Neurology (R.S., D.T.), Sheba Medical Center, Tel Hashomer, Israel.

Correspondence to Ronen R. Leker, MD, Cerebrovascular Service and the Periz and Chantal Sheinberg Cerebrovascular Research Laboratory, Department of Neurology, Hebrew University Hadassah Medical Center, Hadassah Ein Kerem, PO Box 12000, Jerusalem 91120 Israel. E-mail leker{at}cc.huji.ac.il

Background and Purpose— Intracerebral hemorrhage (ICH) is a deadly form of stroke. Pretreatment with statins exerts protective effects in patients with ischemic stroke, but their effects in patients with ICH remains unclear.

Methods— The National Acute Stroke Israeli Surveys (NASIS) included all patients admitted with acute stroke to any of the 28 hospitals nationwide during February through March 2003 and March through April 2007. We compared stroke severity and outcomes of ICH patients who received statins before the index event with those who did not, using multivariable logistic regression models adjusting for the propensity to use statins before the event.

Results— Among 3212 stroke patients, 312 had ICH and 89 of them were receiving statins at the time of the ICH. Patients on statins before ICH had lower baseline NIHSS scores, less systemic complications, higher proportions of good outcome (modified Rankin scale 0 to 3), lower death rates, and higher rates of discharge home or to a rehabilitation facility. On logistic regression analyses statin use before the event was associated with odds ratios of 0.46 for having a severe stroke defined as baseline NIHSS >15 (95% CI; 0.23 to 0.93), 2.97 for having good outcome (95% CI; 1.25 to 7.35) at discharge, and 0.25 for death or nursing facility disposition (95% CI; 0.09 to 0.63).

Conclusions— Use of statins before ICH is associated with reduced mortality and neurological disability and with a higher chance for good outcome, suggesting that statins may be protective in the setting of ICH.

Key Words: intracerebral hemorrhage • statins • neuroprotection • cholesterol