Rising statin use and effect on ischemic stroke outcome.
BACKGROUND
Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) have neuroprotective effects in experimental stroke models and are commonly prescribed in clinical practice. The aim of this study was to determine if patients taking statins before hospital admission for stroke had an improved clinical outcome.


METHODS
This was an observational study of 436 patients admitted to the National Institutes of Health Suburban Hospital Stroke Program between July 2000 and December 2002. Self-reported risk factors for stroke were obtained on admission. Stroke severity was determined by the admission National Institutes of Health Stroke Scale score. Good outcome was defined as a Rankin score < 2 at discharge. Statistical analyses used univariate and multivariate logistic regression models.


RESULTS
There were 436 patients with a final diagnosis of ischemic stroke; statin data were available for 433 of them. A total of 95/433 (22%) of patients were taking a statin when they were admitted, rising from 16% in 2000 to 26% in 2002. Fifty-one percent of patients taking statins had a good outcome compared to 38% of patients not taking statins (p = 0.03). After adjustment for confounding factors, statin pretreatment was associated with a 2.9 odds (95% CI: 1.2-6.7) of a good outcome at the time of hospital discharge.


CONCLUSIONS
The proportion of patients taking statins when they are admitted with stroke is rising rapidly. Statin pretreatment was significantly associated with an improved functional outcome at discharge. This finding could support the early initiation of statin therapy after stroke.
Yoon
Sung Sug
SS
Stroke Neuroscience Unit, NINDS/NIH, Bethesda, MD 20892, USA. sungsyoon@yahoo.com <sungsyoon@yahoo.com>
Dambrosia
James
J
Chalela
Julio
J
Ezzeddine
Mustapha
M
Warach
Steven
S
Haymore
Joseph
J
Davis
Lisa
L
Baird
Alison E
AE
D000368:Aged; D002545:Brain Ischemia / Q000628:therapy; D002543:Cerebral Hemorrhage / Q000628:therapy; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D002546:Ischemic Attack, Transient / Q000628:therapy; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D020521:Stroke / Q000401:mortality / Q000628:therapy*; D015996:Survival Rate; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors