title: Statin therapy does not affect the radiographic and clinical profile of patients with TIA and minor stroke.
abstract: OBJECTIVE
  Acute statin therapy improves neurologic outcome and diminishes infarct growth in animal models of stroke. Clinical studies suggest that premorbid and early statin use is associated with improved outcome after major stroke. We studied the association between statin therapy and radiographic and clinical outcomes in patients with high-risk TIA and minor stroke.
  
  
  METHODS
  Patients with high-risk TIA and minor stroke (NIHSS ≤3) were prospectively enrolled within 24 hours of symptom onset. Patients were followed clinically for 3 months, and a subset had a repeat MR imaging at 90 days.
  
  
  RESULTS
  Of 418 patients, 23% were prescribed statins before their stroke. Statins were continued in 20% and initiated in 42%. Patients on prior statin therapy were older and more hypertensive, treated with aspirin, and more likely to have symptomatic carotid disease compared with those not on statin. Adjusting for these differences, prior statin treatment was not associated with DWI positivity (adjusted OR = 1.3; 95% CI, 0.77-2.1; P = .32) or smaller median baseline infarct volume, 1.1 mL (interquartile range = 4) versus 1 mL (interquartile range = 2.5; P = .56). Early or continued treatment with statins did not improve the risk of clinical deterioration (adjusted OR = 0.66; 95% CI, 0.27-1.6; P = .35) or poor functional outcome at 3 months (adjusted OR = 0.66; 95% CI, 0.35-1.24; P = .19).
  
  
  CONCLUSIONS
  Prestroke or early-stroke statin therapy was not associated with a reduction in the number of DWI lesions, infarct volume, or improved clinical or functional outcome at 3 months. The effect of acute statin treatment in patients with ischemic stroke/TIA remains unclear and needs further investigation.
authors.affiliation: From the Departments of Clinical Neurosciences (N.A., J.I.C., M.C.C., A.Q., M.G., S.B.C.) Division of Cerebrovascular Disease (N.A., T.R.), Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida. nasdaghi@med.miami.edu.
authors.forename: N
authors.initials: N
authors.lastname: Asdaghi
authors.affiliation: From the Departments of Clinical Neurosciences (N.A., J.I.C., M.C.C., A.Q., M.G., S.B.C.).
authors.forename: J I
authors.initials: JI
authors.lastname: Coulter
authors.affiliation: Radiology (J.M., M.G., S.B.C.).
authors.forename: J
authors.initials: J
authors.lastname: Modi
authors.affiliation: From the Departments of Clinical Neurosciences (N.A., J.I.C., M.C.C., A.Q., M.G., S.B.C.).
authors.forename: M C
authors.initials: MC
authors.lastname: Camden
authors.affiliation: From the Departments of Clinical Neurosciences (N.A., J.I.C., M.C.C., A.Q., M.G., S.B.C.).
authors.forename: A
authors.initials: A
authors.lastname: Qazi
authors.affiliation: From the Departments of Clinical Neurosciences (N.A., J.I.C., M.C.C., A.Q., M.G., S.B.C.) Radiology (J.M., M.G., S.B.C.).
authors.forename: M
authors.initials: M
authors.lastname: Goyal
authors.affiliation: Division of Cerebrovascular Disease (N.A., T.R.), Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida.
authors.forename: T
authors.initials: T
authors.lastname: Rundek
authors.affiliation: From the Departments of Clinical Neurosciences (N.A., J.I.C., M.C.C., A.Q., M.G., S.B.C.) Radiology (J.M., M.G., S.B.C.) Hotchkiss Brain Institute (S.B.C.), University of Calgary, Calgary, Alberta, Canada.
authors.forename: S B
authors.initials: SB
authors.lastname: Coutts
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D038524:Diffusion Magnetic Resonance Imaging; D018450:Disease Progression; D061345:Early Medical Intervention; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D002546:Ischemic Attack, Transient / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000187:drug effects; D012008:Recurrence; D020521:Stroke / Q000175:diagnosis* / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors