Early statin use in ischemic stroke patients treated with recanalization therapy

Retrospective observational study

Jihoon Kang, Nayoung Kim, Tae Hwan Park, Oh Young Bang, Ji Sung Lee, Juneyoung Lee, Moon Ku Han, Seong Ho Park, Philip B. Gorelick, Hee Joon Bae

Research output: Contribution to journalArticle

3 Citations (Scopus)

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). Conclusion: 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.

Original languageEnglish
Article number122
JournalBMC Neurology
Volume15
Issue number1
DOIs
Publication statusPublished - 2015 Jan 1

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Observational Studies
Retrospective Studies
Stroke
Nervous System
Therapeutics
Cerebral Arteries
Intracranial Hemorrhages
Atrial Fibrillation
Registries
Pathologic Constriction
Hospitalization
Odds Ratio
Databases
Confidence Intervals

Keywords

  • Recanalization
  • Statin
  • Stenosis and occlusion
  • Stroke

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Early statin use in ischemic stroke patients treated with recanalization therapy : Retrospective observational study. / Kang, Jihoon; Kim, Nayoung; Park, Tae Hwan; Bang, Oh Young; Lee, Ji Sung; Lee, Juneyoung; Han, Moon Ku; Park, Seong Ho; Gorelick, Philip B.; Bae, Hee Joon.

In: BMC Neurology, Vol. 15, No. 1, 122, 01.01.2015.

Research output: Contribution to journalArticle

Kang, J, Kim, N, Park, TH, Bang, OY, Lee, JS, Lee, J, Han, MK, Park, SH, Gorelick, PB & Bae, HJ 2015, 'Early statin use in ischemic stroke patients treated with recanalization therapy: Retrospective observational study', BMC Neurology, vol. 15, no. 1, 122. https://doi.org/10.1186/s12883-015-0367-4
Kang, Jihoon ; Kim, Nayoung ; Park, Tae Hwan ; Bang, Oh Young ; Lee, Ji Sung ; Lee, Juneyoung ; Han, Moon Ku ; Park, Seong Ho ; Gorelick, Philip B. ; Bae, Hee Joon. / Early statin use in ischemic stroke patients treated with recanalization therapy : Retrospective observational study. In: BMC Neurology. 2015 ; Vol. 15, No. 1.
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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). Conclusion: 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.",
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T2 - Retrospective observational study

AU - Kang, Jihoon

AU - Kim, Nayoung

AU - Park, Tae Hwan

AU - Bang, Oh Young

AU - Lee, Ji Sung

AU - Lee, Juneyoung

AU - Han, Moon Ku

AU - Park, Seong Ho

AU - Gorelick, Philip B.

AU - Bae, Hee Joon

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N2 - 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). Conclusion: 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.

AB - 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). Conclusion: 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.

KW - Recanalization

KW - Statin

KW - Stenosis and occlusion

KW - Stroke

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