Prior statin use may be associated with improved stroke outcome after tissue plasminogen activator.
OBJECTIVE
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.
Alvarez-Sabín
José
J
Neurovascular Research Laboratory, Neurovascular Unit, Neurology Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain.
Huertas
Rafael
R
Quintana
Manolo
M
Rubiera
Marta
M
Delgado
Pilar
P
Ribó
Marc
M
Molina
Carlos A
CA
Montaner
Joan
J
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D012189:Retrospective Studies; D020521:Stroke / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000008:administration & dosage*; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010959:Tissue Plasminogen Activator