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2024-04-14 05:27

Stroke. 2013 Feb;44(2):448-56. doi: 10.1161/STROKEAHA.112.668277. Epub 2013 Jan 3.

Ní Chróinín DAsplund KÅsberg SCallaly ECuadrado-Godia EDíez-Tejedor EDi Napoli MEngelter STFurie KLGiannopoulos SGotto AM JrHannon NJonsson FKapral MKMartí-Fàbregas JMartínez-Sánchez P,Milionis HJMontaner JMuscari APikija SProbstfield JRost NSThrift AGVemmos KKelly PJ.

Source: Neurovascular Unit for Applied Translational Research and Therapeutics, Mater University Hospital/Dublin Academic Medical Centre, University College Dublin, Ireland. This email address is being protected from spambots. You need JavaScript enabled to view it.


Although experimental data suggest that statin therapy may improve neurological outcome after acute cerebral ischemia, the results from clinical studies are conflicting. We performed a systematic review and meta-analysis investigating the relationship between statin therapy and outcome after ischemic stroke.


The primary analysis investigated statin therapy at stroke onset (prestroke statin use) and good functional outcome (modified Rankin score 0 to 2) and death. Secondary analyses included the following: (1) acute poststroke statin therapy (≤ 72 hours after stroke), and (2) thrombolysis-treated patients.


The primary analysis included 113 148 subjects (27 studies). Among observational studies, statin treatment at stroke onset was associated with good functional outcome at 90 days (pooled odds ratio [OR], 1.41; 95% confidence interval [CI], 1.29-1.56; P<0.001), but not 1 year (OR, 1.12; 95% CI, 0.9-1.4; P=0.31), and with reduced fatality at 90 days (pooled OR, 0.71; 95% CI, 0.62-0.82; P<0.001) and 1 year (OR, 0.80; 95% CI, 0.67-0.95; P=0.01). In the single randomized controlled trial reporting 90-day functional outcome, statin treatment was associated with good outcome (OR, 1.5; 95% CI, 1.0-2.24; P=0.05). No reduction in fatality was observed on meta-analysis of data from 3 randomized controlled trials (P=0.9). In studies restricted to of thrombolysis-treated patients, an association between statins and increased fatality at 90 days was observed (pooled OR, 1.25; 95% CI, 1.02-1.52; P=0.03, 3 studies, 4339 patients). However, this association was no longer present after adjusting for age and stroke severity in the largest study (adjusted OR, 1.14; 95% CI, 0.90-1.44; 4012 patients).


In the largest meta-analysis to date, statin therapy at stroke onset was associated with improved outcome, a finding not observed in studies restricted to thrombolysis-treated patients. Randomized trials of statin therapy in acute ischemic stroke are needed.