The effect of statin pretreatment on infarct volume in ischemic stroke.
BACKGROUND
Treatment with statins reduces infarct volume in animal models of ischemic stroke, independently of the effect on cholesterol. This study examined this effect in humans by testing whether patients taking statins at onset of ischemic stroke had smaller infarct volumes than those not taking statins.


METHODS
The study design was a retrospective cohort analysis of all verified ischemic stroke patients admitted to the Medical University of South Carolina Hospital, in 2002-2006, with magnetic resonance diffusion-weighted imaging (DWI). Patients were grouped according to statin status at admission and compared relative to infarct volume, calculated (blinded to statin status) from DWI.


RESULTS
A smaller than median infarct volume following ischemic stroke was associated with the interaction of statin pretreatment and positive diabetes status. This association remained significant (p = 0.01) in multivariable analysis even after controlling for factors related to demographics, comorbidities and risk factors, clinical features on admission, use of other medications and stroke features.


CONCLUSIONS
Among ischemic stroke patients in this study, infarct volume below the median was significantly associated with statin pretreatment among those with diabetes.
Department of Biostatistics, Bioinformatics and Epidemiology, Medical University of South Carolina, Charleston, SC 29425, USA. nicholjs@musc.edu
J S
JS
Nicholas
C J
CJ
Swearingen
J C
JC
Thomas
Z
Z
Rumboldt
P
P
Tumminello
S J
SJ
Patel
D000368:Aged; D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications / Q000188:drug therapy* / Q000473:pathology
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors