Prior statin use in acute ischemic stroke patients with mechanical thrombectomy: A prospective cohort study in China

Quan Liu; Song He; Yapeng Lin; Song Tan; Junshan Zhou; Jie Yang

doi:10.1016/j.clineuro.2023.107988

Prior statin use in acute ischemic stroke patients with mechanical thrombectomy: A prospective cohort study in China

Clin Neurol Neurosurg. 2023 Nov:234:107988. doi: 10.1016/j.clineuro.2023.107988. Epub 2023 Sep 22.

Authors

Quan Liu¹, Song He², Yapeng Lin², Song Tan³, Junshan Zhou⁴, Jie Yang⁵

Affiliations

¹ Department of Emergency, Chengdu Second People's Hospital, Chengdu, China.
² Department of Neurology, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China.
³ Department of Neurology, Sichuan Provincial People's Hospital, School of Medicine,University of Electronic Science and Technology of China, Chengdu, China.
⁴ Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China. Electronic address: zhjsh333@126.com.
⁵ Department of Neurology, Sichuan Provincial People's Hospital, School of Medicine,University of Electronic Science and Technology of China, Chengdu, China. Electronic address: yangjie1126@163.com.

PMID: 37769498
DOI: 10.1016/j.clineuro.2023.107988

Abstract

Background and purpose: Mechanical thrombectomy (MT) has been proven to be effective for selected patients with acute ischemic stroke (AIS). However, conflicting findings have suggested the association between prior statin use and outcomes in AIS patients with MT, with a particular lack of information in the Chinese population. Via a prospective cohort study, we explored the safety and efficacy of prior statin use in Chinese AIS patients with MT.

Methods: We consecutively enrolled AIS patients treated with MT from the First Affiliated Hospital of Chengdu Medical College and Nanjing First Hospital between June 2015 and June 2022 who were under prior statin use or not. Safety and efficacy outcomes were prospectively followed. The primary outcomes were defined as 90-day favorable outcomes (mRS score 0-2). Secondary outcomes included successful recanalization (TICI≥2b), early neurological improvement (decrease of National Institutes of Health Stroke Scale (NIHSS) score ≥ 4 points at 24 h), symptomatic intracerebral hemorrhage (sICH), and death at 90 days.

Results: We enrolled 334 patients in total, 50 of whom (15.0%) undertaken statins administration before AIS. 117 (35.0%) patients had favorable outcomes at 90 days, 288 (86.2%) patients had successful recanalization, 108 (32.3%) patients achieved early neurological improvement, 41 (12.3%) patients had sICH and 73 (21.9%) patients died within 90 days. The 90-day favorable outcomes were not significantly different (adjusted OR=0.853, 95% CI 0.449-1.620, P = 0.626) between prior statins use group and no statins use group. There was no significant difference in recanalization (adjusted OR=1.466, 95% CI 0.536-4.009, P = 0.456), early neurological improvement (adjusted OR=1.568, 95% CI 0.811-3.032, P = 0.181), sICH (adjusted OR=0.850, 95% CI 0.325-2.224, P = 0.741), ICH (adjusted OR=1.029, 95% CI 0.479-2.490, P = 0.942), and 90-day mortality (adjusted OR=0.381, 95% CI 0.091-1.586, P = 0.185) between the two groups.

Conclusions: Prior statin use may be safe for Chinese AIS patients with MT, but its efficacy warrants further research.

Keywords: Ischemic stroke; Mechanical thrombectomy; Statin.

MeSH terms

Brain Ischemia* / drug therapy
Brain Ischemia* / surgery
Cerebral Hemorrhage / complications
China
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use
Ischemic Stroke* / drug therapy
Ischemic Stroke* / surgery
Prospective Studies
Stroke* / chemically induced
Stroke* / drug therapy
Stroke* / surgery
Thrombectomy
Treatment Outcome

Substances

Hydroxymethylglutaryl-CoA Reductase Inhibitors