title: Outcomes after thrombolysis in AIS according to prior statin use: a registry and review.
abstract: BACKGROUND
  The impact of prior statin use on outcomes after thrombolysis is unclear. We evaluated outcomes of patients treated by IV, intra-arterial (IA) thrombolysis, or combined therapy, according to prior statin use.
  
  
  METHODS
  We analyzed data from a patient registry (606 patients) and conducted a systematic review.
  
  
  RESULTS
  We identified 11 previous studies (6,438 patients) that evaluated the effect of statin use on outcomes after IV thrombolysis (8 studies), IA thrombolysis (2 studies), or a single/combined approach (1 study). In our registry and in most of the retrieved studies, statin users had more risk factors and concomitant antiplatelet treatment than nonstatin users. Regardless of treatment strategy, prior statin use was not associated with favorable outcome (adjusted odds ratio [OR] 1.36; 95 confidence interval [CI] 0.86-2.16), symptomatic intracranial hemorrhage (sICH) (OR 0.57; 95% CI 0.22-1.49), or recanalization (OR 1.87; 95% CI 0.69-5.03). In meta-analysis, prior statin use was not associated with favorable outcome (crude OR 0.99; 95% CI 0.88-1.12), but was associated with an increased risk of sICH (crude OR 1.55; 95% CI 1.23-1.95). However, when the available multivariable associations were combined (5 studies), the effect of prior statin use on risk of sICH was not significant (OR 1.31; 95% CI 0.97-1.76).
  
  
  CONCLUSIONS
  These results suggest no beneficial or detrimental effect of prior statin use in acute stroke patients treated by IV thrombolysis, IA thrombolysis, or combined therapy, although the numbers of patients treated by IA thrombolysis or combined therapy are too small to exclude an effect.
authors.affiliation: Department of Neurology and Stroke Centre, Bichat University Hospital, Paris, France. elena.meseguer@bch.aphp.fr
authors.forename: Elena
authors.initials: E
authors.lastname: Meseguer
authors.forename: Mikael
authors.initials: M
authors.lastname: Mazighi
authors.forename: Bertrand
authors.initials: B
authors.lastname: Lapergue
authors.forename: Julien
authors.initials: J
authors.lastname: Labreuche
authors.forename: Gaia
authors.initials: G
authors.lastname: Sirimarco
authors.forename: Jaime
authors.initials: J
authors.lastname: Gonzalez-Valcarcel
authors.forename: Philippa C
authors.initials: PC
authors.lastname: Lavallée
authors.forename: Lucie
authors.initials: L
authors.lastname: Cabrejo
authors.forename: Céline
authors.initials: C
authors.lastname: Guidoux
authors.forename: Isabelle F
authors.initials: IF
authors.lastname: Klein
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Olivot
authors.forename: Aymeric
authors.initials: A
authors.lastname: Rouchaud
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Desilles
authors.forename: Pierre
authors.initials: P
authors.lastname: Amarenco
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000188:drug therapy*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012042:Registries; D020521:Stroke / Q000188:drug therapy*; D015912:Thrombolytic Therapy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors