title: Preexisting statin use is associated with greater reperfusion in hyperacute ischemic stroke.
abstract: OBJECTIVE
  Statin pretreatment has been associated with improved outcomes in patients with ischemic stroke. Although several mechanisms have been examined in animal models, few have been examined in patients. We hypothesized that patients using statins before stroke onset may have greater reperfusion than patients not using statins.
  
  
  METHODS
  Acute ischemic stroke patients underwent 2 MR scans: within 4.5 (tp1) and at 6 hours (tp2) after stroke onset. Regions of reperfusion were defined by prolonged mean transit time (MTT) at tp1, which normalized at tp2. Four MTT thresholds were assessed to ensure that results were not spuriously based on an arbitrary threshold. Baseline characteristics, relative reperfusion, and change in NIHSS between tp1 and 1-month follow-up (ΔNIHSS) were compared between patients who were using statins at stroke onset and those who were not.
  
  
  RESULTS
  Thirty-one stroke patients were prospectively enrolled; 12 were using statins and 19 were not. Baseline characteristics did not differ between the 2 groups except the statin group had greater coronary artery disease (P=0.03). Patients using statins showed significantly greater reperfusion compared to untreated patients across all MTT thresholds. For MTT of 4 seconds, median relative reperfusion was 50% (interquartile range, 30%-56%) in the preexisting statin group versus 13% (interquartile range, 5%-36%) in the untreated group (P=0.014). The statin group had greater ΔNIHSS (8.8±4.0 points) compared to the untreated group (4.4±5.7 points; P=0.028).
  
  
  CONCLUSIONS
  Statin use before ischemic stroke onset was associated with greater early reperfusion and NIHSS improvement. Further studies in larger populations are required to confirm our preliminary findings.
authors: Washington University, School of Medicine, Department of Neurology, 600 South Euclid Avenue, Campus Box 8111, St. Louis, MO 63110, USA.
authors: Andria L
authors: AL
authors: Ford
authors: Hongyu
authors: H
authors: An
authors: Gina
authors: G
authors: D'Angelo
authors: Rosana
authors: R
authors: Ponisio
authors: Patrick
authors: P
authors: Bushard
authors: Katie D
authors: KD
authors: Vo
authors: William J
authors: WJ
authors: Powers
authors: Weili
authors: W
authors: Lin
authors: Jin-Moo
authors: JM
authors: Lee
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D015424:Reperfusion; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis / Q000503:physiopathology*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors