title: Effect of pre-stroke statin use on stroke severity and early functional recovery: a retrospective cohort study.
abstract: BACKGROUND
  Experimental studies suggest that pre-stroke statin treatment has a dual effect of neuroprotection during ischemia and neurorestoration after ischemic injury. The aim of this study was to evaluate the effect of pre-stroke statin use on initial stroke severity and early clinical outcome.
  
  
  METHODS
  We used a prospective database enrolling patients with acute ischemic stroke from 12 hospitals in Korea between April 2008 and January 2012. Primary endpoint was the initial stroke severity as measured by the National Institutes of Health Stroke Scale (NIHSS) score. Secondary endpoints were good outcome (modified Rankin Scale [mRS], 0-2) and overall mRS distribution at discharge. Multivariable regression model and propensity score (PS) matching were used for statistical analyses.
  
  
  RESULTS
  Among the 8340 patients included in this study, 964 patients (11.6%) were pre-stroke statin users. The initial NIHSS score (mean [95% CI]) was lower among pre-stroke statin users vs. non-users in multivariable analysis (5.7 [5.2-6.3] versus 6.4 [5.9-6.9], p = 0.002) and PS analysis (5.2 [4.7-5.7] versus 5.7 [5.4-6.0], p = 0.043). Pre-stroke statin use was associated with increased achievement of mRS 0-2 outcome (multivariable analysis: OR [95% CI], 1.55 [1.25-1.92], p < 0.001; PS matching: OR [95% CI], 1.47 [1.16-1.88]; p = 0.002) and favorable shift on the overall mRS distribution (multivariable analysis: OR [95% CI], 1.29 [1.12-1.51], p = 0.001; PS matching: OR [95% CI], 1.31 [1.11-1.54]; p = 0.001).
  
  
  CONCLUSIONS
  Pre-stroke statin use was independently associated with lesser stroke severity at presentation and better early functional recovery in patients with acute ischemic stroke.
authors.affiliation: Department of Neurology, Jeju National University Hospital, Jeju National University, Jeju, South Korea. jaychoi@jejunu.ac.kr.
authors.forename: Jay Chol
authors.initials: JC
authors.lastname: Choi
authors.affiliation: Clinical Research Center, Asan Medical Center, Seoul, South Korea. totoro96a@gmail.com.
authors.forename: Ji Sung
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Neurology, Seoul Medical Center, Seoul, South Korea. strokezero@gmail.com.
authors.forename: Tai Hwan
authors.initials: TH
authors.lastname: Park
authors.affiliation: Department of Neurology, Ilsan Paik Hospital, Inje University, Goyang, South Korea. clavicle@chol.com.
authors.forename: Yong-Jin
authors.initials: YJ
authors.lastname: Cho
authors.affiliation: Department of Neurology, Eulji General Hospital, Eulji University, Seoul, South Korea. jmpark@eulji.ac.kr.
authors.forename: Jong-Moo
authors.initials: JM
authors.lastname: Park
authors.affiliation: Department of Neurology, Eulji General Hospital, Eulji University, Seoul, South Korea. cobnut1@gmail.com.
authors.forename: Kyusik
authors.initials: K
authors.lastname: Kang
authors.affiliation: Department of Neurology, Soonchunhyang University College of Medicine, Seoul, South Korea. kblee@schmc.ac.kr.
authors.forename: Kyung Bok
authors.initials: KB
authors.lastname: Lee
authors.affiliation: Department of Neurology, Eulji University Hospital, Daejeon, South Korea. sjoolee@eulji.ac.kr.
authors.forename: Soo-Joo
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: Department of Neurology, Eulji University Hospital, Daejeon, South Korea. yungchai73@gmail.com.
authors.forename: Youngchai
authors.initials: Y
authors.lastname: Ko
authors.affiliation: Department of Neurology, Yeungnam University Hospital, Daegu, South Korea. junlee@ynu.ac.kr.
authors.forename: Jun
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Neurology, Chonnam National University Hospital, Gwangju, South Korea. alldelight2@jnu.ac.kr.
authors.forename: Joon-Tae
authors.initials: JT
authors.lastname: Kim
authors.affiliation: Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, South Korea. ykh1030@hallym.or.kr.
authors.forename: Kyung-Ho
authors.initials: KH
authors.lastname: Yu
authors.affiliation: Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, South Korea. ssbrain@hallym.ac.kr.
authors.forename: Byung-Chul
authors.initials: BC
authors.lastname: Lee
authors.affiliation: Department of Neurology, Dong-A University College of Medicine, Busan, South Korea. gcha@daunet.donga.ac.kr.
authors.forename: Jae-Kwan
authors.initials: JK
authors.lastname: Cha
authors.affiliation: Department of Neurology, Dong-A University College of Medicine, Busan, South Korea. kdh6542@hanmail.net.
authors.forename: Dae-Hyun
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Department of Biostatistics, Korea University College of Medicine, Seoul, South Korea. jyleeuf@korea.ac.kr.
authors.forename: Juneyoung
authors.initials: J
authors.lastname: Lee
authors.affiliation: Department of Neurology, Dongguk University Ilsan Hospital, Goyang, South Korea. kdongeog@duih.org.
authors.forename: Dong-Eog
authors.initials: DE
authors.lastname: Kim
authors.affiliation: Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea. museum127@gmail.com.
authors.forename: Myung Suk
authors.initials: MS
authors.lastname: Jang
authors.affiliation: Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea. Kim.BJ.Stroke@gmail.com.
authors.forename: Beom Joon
authors.initials: BJ
authors.lastname: Kim
authors.affiliation: Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea. mkhan@chol.com.
authors.forename: Moon-Ku
authors.initials: MK
authors.lastname: Han
authors.affiliation: Department of Neurology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea. braindoc@snu.ac.kr.
authors.forename: Hee-Joon
authors.initials: HJ
authors.lastname: Bae
authors.affiliation: Department of Neurology, Ilsan Paik Hospital, Inje University, Goyang, South Korea. nrhks@paik.ac.kr.
authors.forename: Keun-Sik
authors.initials: KS
authors.lastname: Hong
mesh_terms: D000368:Aged; D002545:Brain Ischemia / Q000188:drug therapy / Q000503:physiopathology* / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010351:Patient Discharge; D011446:Prospective Studies; D020127:Recovery of Function; D012042:Registries; D012044:Regression Analysis; D056910:Republic of Korea; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000188:drug therapy / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors