title: Does statin in the acute phase of ischemic stroke improve outcome after intravenous thrombolysis? A retrospective study.
abstract: BACKGROUND
  In recent years, the medical literature has shown that statin treatment before and in the acute phase of ischemic stroke has a positive impact on outcome. The possible effect of statins during the acute phase has never been assessed in thrombolysed patients, and the few studies investigating a possible association between prior statin use and outcome after thrombolysis have reported controversial results. The aim of the present study was to assess whether statin treatment started in the acute phase of stroke (within 24h) or before stroke and continued during the acute phase may influence short- and long-term outcome in patients receiving intravenous (IV) thrombolysis.
  
  
  METHODS
  We conducted a retrospective analysis of 250 patients treated with IV thrombolysis. Outcome measures were 3-month good functional outcome (modified Rankin Scale ≤ 2); neurological improvement (reduction ≥ 4 points on the National Institutes of Health Stroke Scale [NIHSS]) between 24 and 72 h; and symptomatic intracerebral hemorrhage (brain hematoma associated with NIHSS deterioration ≥ 4 points) within 72 h.
  
  
  RESULTS
  Multivariate analysis showed that statin treatment started in the acute phase of stroke was associated with both good functional outcome (OR: 6.18; 95% CI: 1.43-26.62; P=0.015) and neurological improvement (OR: 9.47; 95% CI: 1.98-45.37; P=0.005), whereas statin treatment started before stroke and continued in the acute phase was associated with symptomatic intracerebral hemorrhage (OR: 6.65; 95% CI: 1.58-29.12; P=0.010).
  
  
  CONCLUSIONS
  Our data suggest that statin treatment started within 24h after IV thrombolysis, but not statin treatment started before stroke and continued in the acute phase, may improve short- and long-term outcome.
authors.affiliation: Division of Neurology, Department of Neurosciences, Piazzale A. Stefani 1, 37126 Verona, Italy. manuel_cappellari@libero.it
authors.forename: Manuel
authors.initials: M
authors.lastname: Cappellari
authors.forename: Cristina
authors.initials: C
authors.lastname: Deluca
authors.forename: Michele
authors.initials: M
authors.lastname: Tinazzi
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Tomelleri
authors.forename: Monica
authors.initials: M
authors.lastname: Carletti
authors.forename: Antonio
authors.initials: A
authors.lastname: Fiaschi
authors.forename: Paolo
authors.initials: P
authors.lastname: Bovi
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Moretto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D020521:Stroke / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors