Blog | Tuesday, April 23, 2013

QD: News Every Day--Statins may lessen stroke severity, study says


Pretreatment with statins was associated with lower stroke severity, at high doses as well as at low to moderate ones, a study found.

To examine the effects of pretreatment with statins at high doses (defined as 40 mg of rosuvastatin or 80 mg of any other statin) and low to moderate doses (less than 40 mg of rosuvastatin or less than 80 mg of any other statin) on ischemic stroke severity, researchers conducted an observational study of consecutive admissions to the stroke unit of an academic hospital, the only stroke center for a population of about 750,000 people in Madrid, Spain from 2008 to 2010. Mild stroke severity was defined as National Institutes of Health Stroke Scale (NIHSS) score 5 or less on admission.

Results were published online April 17 in Neurology.

Of 969 ischemic stroke patients, 23% were taking low to moderate doses and 4.1% were taking high doses of statins before their strokes. Statins were associated with lower NIHSS scores on admission. Nonstatin patients had a median score of 4 (interquartile range [IQR], 9) compared to patients taking low to moderate doses (median, 4; IQR, 9) and patients on high doses (median, 2; IQR, 4) (P=0.010).

After adjusting for variables, statins were associated with a higher probability of mild stroke severity in the unmatched analysis (low to moderate doses odds ratio [OR], 1.637; 95% confidence interval [CI], 1.156 to 2.319) (high doses OR, 3.297; 95% CI 1.480 to 7.345) The propensity score matched analysis results showed that statins were associated with a higher probability of mild stroke severity (low to moderate doses OR, 2.023; 95% CI 1.248 to 3.281) (high doses OR, 3.502; 95% CI, 1.477 to 8.300).

A dose effect was not apparent because the confidence intervals overlapped, the authors noted.

They wrote, "This study shows that pretreatment with statins is associated with lower stroke severity and this association is independent of both total cholesterol and low-density lipoprotein cholesterol levels, also suggesting that statins may have a cytoprotective effect that is independent of their lipid-lowering effect."