Does pretreatment with statins improve clinical outcome after stroke? A pilot case-referent study.
OBJECTIVE
In primary and secondary prevention trials, statins have been shown to reduce the risk of stroke. In addition to lipid lowering, statins have a number of antiatherothrombotic and neuroprotective properties. In a preliminary observational study, we explored whether clinical outcome is improved in patients who are on treatment with statins when stroke occurs.


METHODS
We conducted a population-based case-referent study of 25- to 74-year-old stroke patients with, for each case of a patient who was on statin treatment at the onset of stroke (n=125), 2 referent patients who were not treated with statins but were matched for age, gender, year of onset, and stroke subtype (n=250).


RESULTS
The unadjusted odds ratio for early discharge to home (versus late discharge or death) was 1.41 (95% CI 0.91 to 2.17) when patients on statin treatment were compared with referent stroke patients not on statins. Prognostic factors were, in general, more unfavorable among patients on statins. When this was adjusted for in a logistic regression model, the use of statins was a moderately strong but statistically nonsignificant predictor of discharge to home (multiple-adjusted odds ratio 1.42, 95% CI 0.90 to 2.22).


CONCLUSIONS
The statistical power of this case-referent study was such that only large beneficial effects of statins in acute stroke could be confirmed. However, the observed trend, together with experimental observations, is interesting enough to warrant a more detailed analysis of the relationship between statins and stroke outcome.
Jonsson
N
N
Department of Medicine, Umeå University, Umeå, Sweden.
Asplund
K
K
D000208:Acute Disease; D000328:Adult; D017677:Age Distribution; D000368:Aged; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000453:epidemiology; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D016017:Odds Ratio; D010865:Pilot Projects; D011379:Prognosis; D012189:Retrospective Studies; D055502:Secondary Prevention; D017678:Sex Distribution; D019821:Simvastatin / Q000627:therapeutic use*; D020521:Stroke / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology* / Q000517:prevention & control*; D013548:Sweden / Q000453:epidemiology; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D019821:Simvastatin