title: Early statin use is associated with increased risk of infection after stroke.
abstract: BACKGROUND
  Infection after stroke is common and likely detrimental. Given the potent immunomodulatory properties of statins, we hypothesized that early statin use might increase the risk of infection in the immediate post stroke period.
  
  
  METHODS
  In a study cohort of 112 patients with ischemic stroke, we assessed the impact of early statin use on the risk of post stroke infection.
  
  
  RESULTS
  After controlling for stroke severity and patient age, the odds ratio (OR) and 95% confidence interval (CI) for infection in the first 15 days after stroke among patients on a statin by day 3 after stroke was 7.21 (95% CI 1.40-37.98; P = .018). When controlling for univariate predictors of infection, the OR associated for infection associated with statin use actually increased, but was no longer significant (8.49 [95% CI 0.92-77.98]; P = .059). In addition, early statin use was associated with an increase in plasma interleukin-1 receptor antagonist (IL-1ra); IL-1ra was significantly higher in early statin users than in nonstatin users by day 7 after stroke.
  
  
  CONCLUSIONS
  Our data suggest that early statin use appears to be associated with and increased risk of post stroke infection. This risk may, in part, be related to increases in plasma IL-1ra. If these findings are replicated in larger studies, they could have important implications for the timing of statin therapy after stroke.
authors.affiliation: Department of Neurology, University of Washington School of Medicine, Harborview Medical Center, Seattle, WA 98104-2499, USA. kjb@uw.edu
authors.forename: Kyra
authors.initials: K
authors.lastname: Becker
authors.forename: Pat
authors.initials: P
authors.lastname: Tanzi
authors.forename: Angela
authors.initials: A
authors.lastname: Kalil
authors.forename: Dean
authors.initials: D
authors.lastname: Shibata
authors.forename: Kevin
authors.initials: K
authors.lastname: Cain
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003141:Communicable Diseases / Q000097:blood / Q000139:chemically induced* / Q000276:immunology; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D053590:Interleukin 1 Receptor Antagonist Protein / Q000097:blood; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; C507763:IL1RN protein, human; D053590:Interleukin 1 Receptor Antagonist Protein