Effect of pre-stroke statin use on stroke severity and early functional recovery: A retrospective cohort study

Jay Chol Choi, Ji Sung Lee, Tai Hwan Park, Yong Jin Cho, Jong Moo Park, Kyusik Kang, Kyung Bok Lee, Soo Joo Lee, Youngchai Ko, Jun Lee, Joon Tae Kim, Kyung Ho Yu, Byung Chul Lee, Jae Kwan Cha, Dae Hyun Kim, Juneyoung Lee, Dong Eog Kim, Myung Suk Jang, Beom Joon Kim, Moon Ku HanHee Joon Bae, Keun Sik Hong

Research output: Contribution to journalArticle

10 Citations (Scopus)

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.

Original languageEnglish
Article number120
JournalBMC Neurology
Volume15
Issue number1
DOIs
Publication statusPublished - 2015 Jan 1

Fingerprint

Hydroxymethylglutaryl-CoA Reductase Inhibitors
Cohort Studies
Retrospective Studies
Stroke
Propensity Score
National Institutes of Health (U.S.)
Korea

Keywords

  • Acute stroke
  • Outcomes
  • Statins

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Choi, J. C., Lee, J. S., Park, T. H., Cho, Y. J., Park, J. M., Kang, K., ... Hong, K. S. (2015). Effect of pre-stroke statin use on stroke severity and early functional recovery: A retrospective cohort study. BMC Neurology, 15(1), [120]. https://doi.org/10.1186/s12883-015-0376-3

Effect of pre-stroke statin use on stroke severity and early functional recovery : A retrospective cohort study. / Choi, Jay Chol; Lee, Ji Sung; Park, Tai Hwan; Cho, Yong Jin; Park, Jong Moo; Kang, Kyusik; Lee, Kyung Bok; Lee, Soo Joo; Ko, Youngchai; Lee, Jun; Kim, Joon Tae; Yu, Kyung Ho; Lee, Byung Chul; Cha, Jae Kwan; Kim, Dae Hyun; Lee, Juneyoung; Kim, Dong Eog; Jang, Myung Suk; Kim, Beom Joon; Han, Moon Ku; Bae, Hee Joon; Hong, Keun Sik.

In: BMC Neurology, Vol. 15, No. 1, 120, 01.01.2015.

Research output: Contribution to journalArticle

Choi, JC, Lee, JS, Park, TH, Cho, YJ, Park, JM, Kang, K, Lee, KB, Lee, SJ, Ko, Y, Lee, J, Kim, JT, Yu, KH, Lee, BC, Cha, JK, Kim, DH, Lee, J, Kim, DE, Jang, MS, Kim, BJ, Han, MK, Bae, HJ & Hong, KS 2015, 'Effect of pre-stroke statin use on stroke severity and early functional recovery: A retrospective cohort study', BMC Neurology, vol. 15, no. 1, 120. https://doi.org/10.1186/s12883-015-0376-3
Choi, Jay Chol ; Lee, Ji Sung ; Park, Tai Hwan ; Cho, Yong Jin ; Park, Jong Moo ; Kang, Kyusik ; Lee, Kyung Bok ; Lee, Soo Joo ; Ko, Youngchai ; Lee, Jun ; Kim, Joon Tae ; Yu, Kyung Ho ; Lee, Byung Chul ; Cha, Jae Kwan ; Kim, Dae Hyun ; Lee, Juneyoung ; Kim, Dong Eog ; Jang, Myung Suk ; Kim, Beom Joon ; Han, Moon Ku ; Bae, Hee Joon ; Hong, Keun Sik. / Effect of pre-stroke statin use on stroke severity and early functional recovery : A retrospective cohort study. In: BMC Neurology. 2015 ; Vol. 15, No. 1.
@article{db53a278b75a40b1bbe6477ec43f79b1,
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.",
keywords = "Acute stroke, Outcomes, Statins",
author = "Choi, {Jay Chol} and Lee, {Ji Sung} and Park, {Tai Hwan} and Cho, {Yong Jin} and Park, {Jong Moo} and Kyusik Kang and Lee, {Kyung Bok} and Lee, {Soo Joo} and Youngchai Ko and Jun Lee and Kim, {Joon Tae} and Yu, {Kyung Ho} and Lee, {Byung Chul} and Cha, {Jae Kwan} and Kim, {Dae Hyun} and Juneyoung Lee and Kim, {Dong Eog} and Jang, {Myung Suk} and Kim, {Beom Joon} and Han, {Moon Ku} and Bae, {Hee Joon} and Hong, {Keun Sik}",
year = "2015",
month = "1",
day = "1",
doi = "10.1186/s12883-015-0376-3",
language = "English",
volume = "15",
journal = "BMC Neurology",
issn = "1471-2377",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - Effect of pre-stroke statin use on stroke severity and early functional recovery

T2 - A retrospective cohort study

AU - Choi, Jay Chol

AU - Lee, Ji Sung

AU - Park, Tai Hwan

AU - Cho, Yong Jin

AU - Park, Jong Moo

AU - Kang, Kyusik

AU - Lee, Kyung Bok

AU - Lee, Soo Joo

AU - Ko, Youngchai

AU - Lee, Jun

AU - Kim, Joon Tae

AU - Yu, Kyung Ho

AU - Lee, Byung Chul

AU - Cha, Jae Kwan

AU - Kim, Dae Hyun

AU - Lee, Juneyoung

AU - Kim, Dong Eog

AU - Jang, Myung Suk

AU - Kim, Beom Joon

AU - Han, Moon Ku

AU - Bae, Hee Joon

AU - Hong, Keun Sik

PY - 2015/1/1

Y1 - 2015/1/1

N2 - 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.

AB - 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.

KW - Acute stroke

KW - Outcomes

KW - Statins

UR - http://www.scopus.com/inward/record.url?scp=84989229121&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84989229121&partnerID=8YFLogxK

U2 - 10.1186/s12883-015-0376-3

DO - 10.1186/s12883-015-0376-3

M3 - Article

C2 - 26224123

AN - SCOPUS:84989229121

VL - 15

JO - BMC Neurology

JF - BMC Neurology

SN - 1471-2377

IS - 1

M1 - 120

ER -