Statin use before and after acute ischemic stroke onset improves neurological outcome.
The devastating consequences of stroke, both in terms of morbidity and mortality, and the economic implications it has worldwide, coupled with a growing knowledge regarding its pathophysiology, has led to the development of novel therapeutic strategies in recent years that have had an enormous impact on clinical practice and the outcome of stroke patients. While thrombolysis is regarded as the most important of these developments, its relatively narrow therapeutic window and complexity of administration imply that only a minority of stroke patients can benefit from it. Among other strategies, in an attempt to overcome this limitation, research has focused on the development of neuroprotection aimed to salvage ischemic brain tissue by means complementary to reperfusion. Among these approaches, the use of statins stands out, which, by inhibiting the HMG CoA reductase, interfere with the formation of isoprenoid intermediates in the biosynthesis of cholesterol, and have been shown to have a positive impact in both the incidence and outcome of acute stroke. The main results of animal models, observational studies, clinical trials and opinion articles available in the medical literature covering the effect of statins on acute brain ischemia will be reviewed in order to provide in-depth information regarding their mode of action and current evidence regarding their potential benefits for ischemic stroke patients.
Salat
David
D
Neurovascular Research Laboratory, Neurovascular Unit, Institut de Recerca, Hospital Vall d'Hebron, Pg Vall d'Hebron 119-129, 08035 Barcelona, Spain.
Ribosa
Roser
R
Garcia-Bonilla
Lidia
L
Montaner
Joan
J
D000818:Animals; D002545:Brain Ischemia / Q000188:drug therapy* / Q000534:rehabilitation; D004359:Drug Therapy, Combination; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D018696:Neuroprotective Agents / Q000494:pharmacology / Q000627:therapeutic use*; D020521:Stroke / Q000188:drug therapy*; D000071939:Stroke Rehabilitation; D015912:Thrombolytic Therapy / Q000009:adverse effects; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D018696:Neuroprotective Agents