Rising statin use and effect on ischemic stroke outcome

Sung Sug Yoon¹ , James Dambrosia² , Julio Chalela³ , Mustapha Ezzeddine⁴ , Steven Warach³ , Joseph Haymore⁵ , Lisa Davis³ and Alison E Baird¹

¹Stroke Neuroscience Unit, NINDS/NIH, Bethesda, MD 20892, USA

²Biostatistics Branch, NINDS/NIH, Bethesda, MD 20892, USA

³Section on Stroke Diagnostics and Therapeutics, NINDS/NIH, Bethesda, MD 20892, USA

⁴Neurology/Neurosurgery, Emory University, Atlanta, GA 30322, USA

⁵Center for Neuro Services (CNS), Washington Adventist Hospital, Takoma Park, Maryland 20912, USA

author email corresponding author email

BMC Medicine 2004, 2:4doi:10.1186/1741-7015-2-4


Published:	23 March 2004

Abstract

Background

Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) have neuroprotective effects in experimental stroke models and are commonly prescribed in clinical practice. The aim of this study was to determine if patients taking statins before hospital admission for stroke had an improved clinical outcome.

Methods

This was an observational study of 436 patients admitted to the National Institutes of Health Suburban Hospital Stroke Program between July 2000 and December 2002. Self-reported risk factors for stroke were obtained on admission. Stroke severity was determined by the admission National Institutes of Health Stroke Scale score. Good outcome was defined as a Rankin score < 2 at discharge. Statistical analyses used univariate and multivariate logistic regression models.

Results

There were 436 patients with a final diagnosis of ischemic stroke; statin data were available for 433 of them. A total of 95/433 (22%) of patients were taking a statin when they were admitted, rising from 16% in 2000 to 26% in 2002. Fifty-one percent of patients taking statins had a good outcome compared to 38% of patients not taking statins (p = 0.03). After adjustment for confounding factors, statin pretreatment was associated with a 2.9 odds (95% CI: 1.2–6.7) of a good outcome at the time of hospital discharge.

Conclusions

The proportion of patients taking statins when they are admitted with stroke is rising rapidly. Statin pretreatment was significantly associated with an improved functional outcome at discharge. This finding could support the early initiation of statin therapy after stroke.