WSO - February 2023 - 201

1095965
WSO
International Journal of Stroke X(X)Escudero-Martínez et al.
Research
Association of statin pre-treatment with
baseline stroke severity and outcome in
patients with acute ischemic stroke and
received reperfusion treatment:
An observational study
Irene Escudero-Martínez1,2 , Marius Matusevicius3,4
,
Ana Pavia-Nunes5, Petr Sevcik6 , Miroslava Nevsimalova7,
Viiu-Marika Rand8 , Janika Kõrv9 , Manuel Cappellari10
Robert Mikulik11, Danilo Toni12 and Niaz Ahmed3,4
Abstract
Background: Statins have an important role in stroke prevention, especially in high-risk populations and may also affect
the initial stroke severity and outcomes in patients taking them before an ischemic stroke.
Aims: Our aim was to evaluate the association of statin pre-treatment with the severity in acute ischemic stroke (AIS).
Methods: We analyzed AIS patients received intravenous thrombolysis (IVT) and/or endovascular thrombectomy (EVT) and
recorded in the SITS International Thrombolysis and Thrombectomy Registry from 2011 to 2017. We identified patients with
statin information at baseline. The primary outcome was baseline National Institutes of Health Stroke Scale (NIHSS)
score. Secondary outcomes were NIHSS score at 24 h, symptomatic intracerebral hemorrhage (SICH) and functional
outcome at 90 days after acute intervention. Multivariable linear and logistic regression and propensity score matching
(PSM) was used to quantify the effect of statin pre-treatment.
Results: Of 93,849 patients, 23,651 (25.2%) were treated with statins prior the AIS. Statin pre-treatment group was
older and had higher comorbidity. Median NIHSS at baseline was similar between groups. In the adjusted and PSM analysis,
statin pre-treatment was inversely associated with baseline NIHSS (odds ratio (OR) = 0.77, 95% confidence interval
(CI) = 0.6-0.99 and OR for PSM 0.73, 95% CI = 0.54-0.99, p = 0.004) and independently associated with mild stroke
defined as NIHSS ⩽8 in adjusted and PSM analysis (OR = 1.21, 95% CI = 1.1-1.34, p < 0.001 and OR for PSM 1.17, 95%
CI = 1.05-1.31, p = 0.007). Regarding secondary outcomes, there were no differences in functional outcomes, death nor
SICH rates between groups.
1 Department of Neurology, Hospital Universitari Politècnic La Fe, Valencia, Spain
2 Neurovascular Research Laboratory, Instituto Biomedicina Sevilla-IBiS, Sevilla, Spain
3 Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
4 Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
5 Stroke Unit, Hospital de São José, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
6 Department of Neurology, Faculty of Medicine in Pilsen, Charles University, Prague, Czech Republic
7 Department of Neurology, Comprehensive Cerebrovascular Center, Hospital Ceske Budejovice, České Budějovice, Czech Republic
8 Department of Neurology, North Estonia Medical Centre Foundation, Tallinn, Estonia
9 Institute of Clinical Medicine, Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia
10 Stroke Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
11 International Clinical Research Center and Department of Neurology, St. Anne's University Hospital and Faculty of Medicine at Masaryk
University, Brno, Czech Republic
12 Department of Human Neurosciences, University La Sapienza Rome, Rome, Italy
Corresponding author:
Irene Escudero-Martínez, Department of Neurology, Hospital Universitari Politècnic La Fe, Av. Fernando Abril Martorell 126, Valencia CP 46026,
Spain.
Email: imesmar@gmail.com
International Journal of Stroke, 18(2)
,
https://doi.org/10.1177/17474930221095965
International Journal of Stroke
2023, Vol. 18(2) 201 -207
© 2022 World Stroke Organization
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DOI: 10.1177/17474930221095965
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