The beneficial effect of statins treatment by stroke subtype

Eur J Neurol. 2009 Jan;16(1):127-33. doi: 10.1111/j.1468-1331.2008.02370.x. Epub 2008 Nov 25.

Abstract

Background and purpose: Statins have shown some protective effect after ischaemic stroke in observational studies. However, this effect has never been assessed by etiological subtypes.

Methods: Observational study using data from the Stroke Unit Data Bank from consecutive patients with cerebral infarction. Variables analyzed: demographic data, cardiovascular risk factors, treatment with statins at stroke onset, stroke severity, stroke subtype, in-hospital complications, length of stay, and functional status at discharge (modified Rankin Scale).

Results: A total of 2742 patients were included, 1539 were men. Mean age was 69.17 years (SD 12.19). Of these, 281 patients (10.2%) were receiving statins when admitted. The logistic regression analyses showed that previous treatment with statins was an independent predictor for better outcome at discharge among all strokes (OR, 2.08; 95% CI, 1.39 to 3.1) as well as for the atherothrombotic (OR, 2.79; 95% CI, 1.33 to 5.84) and lacunar strokes (OR, 2.28; 95% CI, 1.15 to 4.52) after adjustment for demographic data, risk factors, previous treatments, stroke subtypes, stroke severity, in-hospital complications and length of stay. This benefit was not observed either in cardioembolic or in other etiology strokes.

Conclusions: Previous treatment with statins is an independent factor associated with good outcomes in patients with ischaemic stroke. Atherothrombotic and small vessel strokes show the greatest benefit.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Brain Ischemia / drug therapy*
  • Brain Ischemia / epidemiology
  • Cohort Studies
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Intracranial Arteriosclerosis / drug therapy
  • Intracranial Arteriosclerosis / epidemiology
  • Intracranial Thrombosis / drug therapy*
  • Intracranial Thrombosis / epidemiology
  • Male
  • Middle Aged
  • Prospective Studies
  • Stroke / classification
  • Stroke / drug therapy*
  • Stroke / epidemiology
  • Stroke, Lacunar / drug therapy*
  • Stroke, Lacunar / epidemiology
  • Treatment Outcome

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors