Document Detail


Preexisting statin use is associated with greater reperfusion in hyperacute ischemic stroke.
MedLine Citation:
PMID:  21454815     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND PURPOSE: Statin pretreatment has been associated with improved outcomes in patients with ischemic stroke. Although several mechanisms have been examined in animal models, few have been examined in patients. We hypothesized that patients using statins before stroke onset may have greater reperfusion than patients not using statins.
METHODS: Acute ischemic stroke patients underwent 2 MR scans: within 4.5 (tp1) and at 6 hours (tp2) after stroke onset. Regions of reperfusion were defined by prolonged mean transit time (MTT) at tp1, which normalized at tp2. Four MTT thresholds were assessed to ensure that results were not spuriously based on an arbitrary threshold. Baseline characteristics, relative reperfusion, and change in NIHSS between tp1 and 1-month follow-up (ΔNIHSS) were compared between patients who were using statins at stroke onset and those who were not.
RESULTS: Thirty-one stroke patients were prospectively enrolled; 12 were using statins and 19 were not. Baseline characteristics did not differ between the 2 groups except the statin group had greater coronary artery disease (P=0.03). Patients using statins showed significantly greater reperfusion compared to untreated patients across all MTT thresholds. For MTT of 4 seconds, median relative reperfusion was 50% (interquartile range, 30%-56%) in the preexisting statin group versus 13% (interquartile range, 5%-36%) in the untreated group (P=0.014). The statin group had greater ΔNIHSS (8.8±4.0 points) compared to the untreated group (4.4±5.7 points; P=0.028).
CONCLUSIONS: Statin use before ischemic stroke onset was associated with greater early reperfusion and NIHSS improvement. Further studies in larger populations are required to confirm our preliminary findings.
Authors:
Andria L Ford; Hongyu An; Gina D'Angelo; Rosana Ponisio; Patrick Bushard; Katie D Vo; William J Powers; Weili Lin; Jin-Moo Lee
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural     Date:  2011-03-31
Journal Detail:
Title:  Stroke; a journal of cerebral circulation     Volume:  42     ISSN:  1524-4628     ISO Abbreviation:  Stroke     Publication Date:  2011 May 
Date Detail:
Created Date:  2011-04-26     Completed Date:  2011-06-30     Revised Date:  2014-09-24    
Medline Journal Info:
Nlm Unique ID:  0235266     Medline TA:  Stroke     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1307-13     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
Follow-Up Studies
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Male
Middle Aged
Prognosis
Prospective Studies
Reperfusion*
Retrospective Studies
Stroke / diagnosis,  physiopathology*
Time Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
1 KL2 RR 024994-01/RR/NCRR NIH HHS; 1 UL1 RR024992-01/RR/NCRR NIH HHS; 5P50NS055977/NS/NINDS NIH HHS; 5R01NS054079/NS/NINDS NIH HHS; KL2 RR024994/RR/NCRR NIH HHS; KL2 RR024994-01/RR/NCRR NIH HHS; P50 NS055977/NS/NINDS NIH HHS; P50 NS055977-03/NS/NINDS NIH HHS; UL1 RR024992/RR/NCRR NIH HHS; UL1 RR024992-01/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Hydroxymethylglutaryl-CoA Reductase Inhibitors
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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