title: Early statin use in ischemic stroke patients treated with recanalization therapy: retrospective observational study.
abstract: BACKGROUND
  We aimed to determine whether early statin use following recanalization therapy improves the functional outcome of ischemic stroke.
  
  
  METHODS
  Using a prospective stroke registry database, we identified a consecutive 337 patients within 6 h of onset who had symptomatic stenosis or occlusion of major cerebral arteries and received recanalization therapy. Based on commencement of statin therapy, patients were categorized into administration on the first (D1, 13.4%), second (D2, 20.8%) and third day or later (D ≥ 3, 15.4%) after recanalization therapy, and no use (NU, 50.4%). The primary efficacy outcome was a 3-month modified Rankin Scale score of 0-1, and the secondary outcomes were neurologic improvement, neurologic deterioration and symptomatic hemorrhagic transformation during hospitalization.
  
  
  RESULTS
  Earlier use of statin was associated with a better primary outcome in a dose-response relationship (P for trend = 0.01) independent of premorbid statin use, stroke history, atrial fibrillation, stroke subtype, calendar year, and methods of recanalization therapy. The odds of a better primary outcome increased in D1 compared to NU (adjusted odds ratio, 2.96; 95% confidence interval, 1.19-7.37). Earlier statin use was significantly associated with less neurologic deterioration and symptomatic hemorrhagic transformation in bivariate analyses but not in multivariable analyses. Interaction analysis revealed that the effect of early statin use was not altered by stroke subtype and recanalization modality (P for interaction = 0.97 and 0.26, respectively).
  
  
  CONCLUSIONS
  Early statin use after recanalization therapy in ischemic stroke may improve the likelihood of a better functional outcome without increasing the risk of intracranial hemorrhage.
authors.affiliation: Department of Neurology, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea. rheizer@naver.com.
authors.forename: Jihoon
authors.initials: J
authors.lastname: Kang
authors.affiliation: Department of Neurology, Cerebrovascular center, Seoul National University Bundang Hospital, Seoul National University, Seongnam, Korea. juli8012@hanmail.net.
authors.forename: Nayoung
authors.initials: N
authors.lastname: Kim
authors.affiliation: Department of Neurology, Seoul Medical Center, Seoul, Korea. strokezero@gmail.com.
authors.forename: Tae Hwan
authors.initials: TH
authors.lastname: Park
authors.affiliation: Department of Neurology, Stroke and Cerebrovascular center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. nmboy@unitel.co.kr.
authors.forename: Oh Young
authors.initials: OY
authors.lastname: Bang
authors.affiliation: Clinical Research Center, Asan Medical Center, Seoul, Korea. totoro96a@gmail.com.
authors.forename: Ji Sung
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Biostatistics, Korea University College of Medicine, Seoul, Korea. jyleeuf@korea.ac.kr.
authors.forename: Juneyoung
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Neurology, Cerebrovascular center, Seoul National University Bundang Hospital, Seoul National University, Seongnam, Korea. mkhan@snu.ac.kr.
authors.forename: Moon-Ku
authors.initials: MK
authors.lastname: Han
authors.affiliation: Department of Neurology, Cerebrovascular center, Seoul National University Bundang Hospital, Seoul National University, Seongnam, Korea. nrpsh@snubh.org.
authors.forename: Seong-Ho
authors.initials: SH
authors.lastname: Park
authors.affiliation: Department of Translational Science and Molecular Medicine, Michigan State University College of Human Medicine & Saint Mary's Health Care at Mercy Health, Grand Rapids, Michigan, USA. pgorelic@trinity-health.org.
authors.forename: Philip B
authors.initials: PB
authors.lastname: Gorelick
authors.affiliation: Department of Neurology, Cerebrovascular center, Seoul National University Bundang Hospital, Seoul National University, Seongnam, Korea. braindoc@snu.ac.kr.
authors.forename: Hee-Joon
authors.initials: HJ
authors.lastname: Bae
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002545:Brain Ischemia / Q000150:complications / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006760:Hospitalization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D020300:Intracranial Hemorrhages / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012042:Registries; D012189:Retrospective Studies; D020521:Stroke / Q000150:complications; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors