The THRombolysis and STatins (THRaST) study.
OBJECTIVE
To assess the impact on stroke outcome of statin use in the acute phase after IV thrombolysis.


METHODS
Multicenter study on prospectively collected data of 2,072 stroke patients treated with IV thrombolysis. Outcome measures of efficacy were neurologic improvement (NIH Stroke Scale [NIHSS] ≤ 4 points from baseline or NIHSS = 0) and major neurologic improvement (NIHSS ≤ 8 points from baseline or NIHSS = 0) at 7 days and favorable (modified Rankin Scale [mRS] ≤ 2) and excellent functional outcome (mRS ≤ 1) at 3 months. Outcome measures of safety were 7-day neurologic deterioration (NIHSS ≥ 4 points from baseline or death), symptomatic intracerebral hemorrhage type 2 with NIHSS ≥ 4 points from baseline or death within 36 hours, and 3-month death.


RESULTS
Adjusted multivariate analysis showed that statin use in the acute phase was associated with neurologic improvement (odds ratio [OR] 1.68, 95% confidence interval [CI] 1.26-2.25; p < 0.001), major neurologic improvement (OR 1.43, 95% CI 1.11-1.85; p = 0.006), favorable functional outcome (OR 1.63, 95% CI 1.18-2.26; p = 0.003), and a reduced risk of neurologic deterioration (OR: 0.31, 95% CI 0.19-0.53; p < 0.001) and death (OR 0.48, 95% CI 0.28-0.82; p = 0.007).


CONCLUSIONS
Statin use in the acute phase of stroke after IV thrombolysis may positively influence short- and long-term outcome.
SSO Stroke Unit, U.O. Neurologia d.O., DAI di Neuroscienze, Azienda Ospedaliera Universitaria Integrata, Italy. manuel_cappellari@libero.it
Manuel
M
Cappellari
Paolo
P
Bovi
Giuseppe
G
Moretto
Andrea
A
Zini
Patrizia
P
Nencini
Maria
M
Sessa
Mauro
M
Furlan
Alessandro
A
Pezzini
Giovanni
G
Orlandi
Maurizio
M
Paciaroni
Tiziana
T
Tassinari
Gaetano
G
Procaccianti
Vincenzo
V
Di Lazzaro
Luigi
L
Bettoni
Carlo
C
Gandolfo
Giorgio
G
Silvestrelli
Maurizia
M
Rasura
Giuseppe
G
Martini
Maurizio
M
Melis
Maria Vittoria
MV
Calloni
Fabio
F
Chiodo-Grandi
Simone
S
Beretta
Maria
M
Guarino
Maria Concetta
MC
Altavista
Simona
S
Marcheselli
Giampiero
G
Galletti
Laura
L
Adobbati
Massimo
M
Del Sette
Armando
A
Mancini
Daniele
D
Orrico
Serena
S
Monaco
Anna
A
Cavallini
Rossella
R
Sciolla
Francesco
F
Federico
Umberto
U
Scoditti
Fabio
F
Brusaferri
Claudio
C
Grassa
Luigi
L
Specchio
Maria Roberta
MR
Bongioanni
Marco
M
Sparaco
Mauro
M
Zampolini
Gabriele
G
Greco
Rinaldo
R
Colombo
Bruno
B
Passarella
Alessandro
A
Adami
Domenico
D
Consoli
Danilo
D
Toni
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009460:Neurologic Examination; D017063:Outcome Assessment, Health Care; D011446:Prospective Studies; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000188:drug therapy*; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use*; D015898:Tomography Scanners, X-Ray Computed
D005343:Fibrinolytic Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010959:Tissue Plasminogen Activator