title: Pre-stroke use of statins on stroke outcome: a meta-analysis of observational studies.
abstract: BACKGROUND
  Animal pre-clinical studies suggest that statins may have neuroprotective effects in acute ischaemic stroke. Statins might also increase the risk of developing haemorrhagic transformation after thrombolytic treatment.
  
  
  METHODS
  We performed a systematic review and included studies that compared good functional outcome, defined as a modified Rankin Scale (mRS) score < or = 2 at 3 months, in-hospital mortality and risk of symptomatic haemorrhagic transformation, between pre -stroke statin users and non users with acute ischaemic stroke.
  
  
  RESULTS
  Eleven studies met our predefined inclusion criteria. Statin therapy before stroke-onset was associated with a lower risk of in-hospital mortality (OR 0.56; 95% CI: 0.40 to 0.78, P < 0.0006). There was no difference between the two groups for good functional outcome at 3 months (OR 1.01; 95% CI: 0.64 to 1.61, P = 0.96). Statin use was associated with an increased risk of developing symptomatic haemorrhagic transformation after thrombolytic therapy (OR 2.34; 95% CI 1.31 to 4.17, P = 0.004).
  
  
  CONCLUSIONS
  Our meta-analysis suggests that pretreatment with statins does not improve 3 months functional outcome, defined as independence on mRS, but decreases in-hospital mortality and increases the risk of developing a symptomatic haemorrhagic transformation in patients treated with thrombolysis.
authors.affiliation: Department of Neurology, Universitair Ziekenhuis Brussel, Center for Neurosciences, Vrije Universiteit Brussel, Brussel, Belgium. ann.cordenier@uzbrussel.be
authors.forename: Ann
authors.initials: A
authors.lastname: Cordenier
authors.forename: Ann
authors.initials: A
authors.lastname: De Smedt
authors.forename: Raf
authors.initials: R
authors.lastname: Brouns
authors.forename: Maarten
authors.initials: M
authors.lastname: Uyttenboogaart
authors.forename: Sylvie
authors.initials: S
authors.lastname: De Raedt
authors.forename: Gert-Jan
authors.initials: GJ
authors.lastname: Luijckx
authors.forename: Jacques
authors.initials: J
authors.lastname: De Keyser
mesh_terms: D000328:Adult; D002543:Cerebral Hemorrhage / Q000517:prevention & control; D017052:Hospital Mortality; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D019370:Observation; D012720:Severity of Illness Index; D020521:Stroke / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors